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Childhood urolithiasis (kidney stones) is common in young Swiss males, often linked to infections or metabolic issues. Analysis revealed infectious stones (struvite) in younger children and idiopathic stones (calcium oxalate) in older ones.
Area of Science:
- Pediatric Nephrology
- Urology
- Biochemistry
Background:
- Urolithiasis in children presents unique etiological challenges compared to adults.
- Understanding the causes of pediatric kidney stones is crucial for effective management and prevention.
- Previous studies have highlighted varying prevalence and causes of urolithiasis across different pediatric age groups.
Purpose of the Study:
- To investigate the etiological factors and stone composition in a cohort of children with urolithiasis.
- To analyze the age- and sex-specific incidence of different stone types and causes.
- To determine the prevalence of infectious, metabolic, and idiopathic causes in pediatric urolithiasis.
Main Methods:
- Retrospective analysis of 59 children diagnosed with urolithiasis between 1969 and 1977.
- X-ray diffraction analysis of calculi from 50 patients to determine chemical composition.
- Categorization of etiological factors into infectious, metabolic (including specific conditions like cystinuria, idiopathic hypercalciuria, primary hyperoxaluria), and idiopathic.
Main Results:
- Infectious stones (predominantly struvite) were found in 26 patients, metabolic stones in 15, and idiopathic stones in 18.
- Younger children (0-4 years) showed a male predominance (76%) and a higher incidence of infectious etiology (55%).
- Older children (10-16 years) had a lower rate of infectious stones (20%) but a higher proportion of idiopathic stones (70%).
- Calcium oxalate was the main component of idiopathic stones.
Conclusions:
- Childhood urolithiasis in Switzerland predominantly affects young males and is frequently secondary to identifiable causes.
- Infectious and metabolic etiologies are significant contributors to pediatric kidney stone formation.
- Age-related differences in stone etiology and composition underscore the need for tailored diagnostic and therapeutic approaches in pediatric urolithiasis.
Abstract:
59 children with urolithiasis were seen between 1969 and 1977 (8 1/2 years). Calculi from 50 patients were analyzed by X-ray diffraction. Half of the patients were 0-4 years old, and in this age group males greatly predominated (76%). Calculi in 26 patients were of infectious, and in 15 patients of metabolic origin (cystinuria 7, idiopathic hypercalciuria 5, primary hyperoxaluria 3), whereas 18 were idiopathic. Most infectious stones contained struvite, and most idiopathic stones contained calcium oxalate. An infectious etiology was observed in 55% of the 0-5-year-old children (n = 33), but in only 20% of the 10-16-year-old ones. In contrast, the percentage of idiopathic stones rose from 18% in the youngest to 70% in the oldest age group, although the absolute numbers were similar in all age groups, Childhood urolithiasis in Switzerland is thus primarily observed in young male patients and is usually secondary to a definable cause.