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Urolithiasis in childhood. A study of 181 cases
Insights
Pediatric urolithiasis, or kidney stones in children, is linked to urinary tract malformations and infections. Turkish children in West Berlin showed a higher incidence of urolithiasis compared to German children.
Area of Science:
- Pediatric Urology
- Nephrology
- Epidemiology
Background:
- Urolithiasis (kidney stones) incidence in children is estimated between 1-5%, comparable to adult rates in Central Europe.
- A significant portion of pediatric urolithiasis cases involve patients under 15 years old.
Purpose of the Study:
- To investigate the incidence, causes, and recurrence of urolithiasis in pediatric patients.
- To compare the prevalence of urolithiasis among different ethnic groups in West Berlin.
Main Methods:
- Retrospective analysis of 2,606 urolithiasis patients over 12 years, focusing on 181 pediatric cases.
- Evaluation of causative factors including congenital anomalies, urinary tract infections, and metabolic disorders.
- Stone analysis and follow-up examinations to assess recurrence rates.
Main Results:
- Congenital malformations (35.9%) and urinary tract infections (80.7%) were primary contributing factors, while metabolic disorders were less common (5.5%).
- Phosphate-containing calculi were predominant.
- Recurrent urolithiasis was confirmed in 9.9% of cases, with incomplete surgical removal accounting for 11% of initially suspected recurrences.
- Turkish children born in West Berlin exhibited a 2-2.5 times higher incidence of urolithiasis than their German counterparts.
Conclusions:
- Urinary tract malformations and infections are key drivers of pediatric urolithiasis.
- Accurate diagnosis of recurrent urolithiasis requires careful evaluation to distinguish true recurrence from residual calculi.
- Ethnic disparities in urolithiasis incidence warrant further investigation, particularly concerning Turkish children in West Berlin.
Abstract:
181 of 2,606 patients hospitalized for urolithiasis in 12 years were younger than 15 years (6.9%). In accordance with the data given by other authors, we found the incidence of urolithiasis in children to be 1-5%, which, at least in Central Europe, corresponds approximately with that in adults. The causative factors or cofactors we established were malformation of the kidneys and urinary tract in 35.9%, and infections of the urinary tract in 80.7%. Defined metabolic disorders were found in only 5.5% of patients. Stone analysis showed a predominance of phosphate-containing calculi. Control examinations were done in 154 children over periods of 6 months to 11 years. "Recurrent lithiasis' was seen in 32 patients, however, the exact comparison of pre- and postoperative X-ray films showed that in 17 cases the calculi had not been completely removed during surgery (11%). Consequently, a real recurrent lithiasis was present in 15 children only (9.9%). Since the West Berlin population includes a high percentage of Turkish people, we can conclude from our case material that even those Turkish children who were born in West Berlin suffer from urolithiasis 2-2.5 times as often as German children of the same age-groups.