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Urolithiasis in Australian aboriginal children

C R Thambi Dorai1, P A Dewan, H A Boucaut

  • 1Urology Unit, Women's and Children's Hospital, North Adelaide, Australia.

The Australian and New Zealand Journal of Surgery
|February 1, 1994
PubMed
Summary

Pediatric urolithiasis in Australian Aboriginal children is common, predominantly affecting young males. Ammonium urate and oxalate stones suggest dietary and dehydration factors, with chemical dissolution proving effective for urate stones.

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Area of Science:

  • Pediatric Nephrology
  • Urology
  • Public Health

Background:

  • Urolithiasis presents a significant health concern in pediatric populations.
  • Australian Aboriginal children exhibit unique epidemiological patterns of urolithiasis.

Purpose of the Study:

  • To characterize the clinical presentation and etiological factors of urolithiasis in Australian Aboriginal children.
  • To evaluate the diagnostic accuracy of ultrasound and the efficacy of chemical dissolution therapy.

Main Methods:

  • Retrospective review of 36 Australian Aboriginal children diagnosed with urolithiasis.
  • Analysis of patient demographics, stone composition, diagnostic imaging (ultrasound), and treatment outcomes.
  • Identification of etiological factors including diet, hydration, and gastrointestinal health.

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Main Results:

  • The study included 36 children, with a male predominance and a median age of 2 years or younger.
  • Upper tract stones were prevalent (35/36 patients), with ultrasound demonstrating high diagnostic accuracy (35/36).
  • Ammonium urate and oxalate were the primary stone constituents, implicating dietary factors, dehydration, and recurrent diarrhea. Urinary tract malformations and metabolic disorders were uncommon.

Conclusions:

  • Pediatric urolithiasis in this cohort is strongly associated with environmental and dietary factors rather than congenital anomalies or metabolic disorders.
  • Ultrasound is a reliable diagnostic tool for pediatric urolithiasis.
  • Chemical dissolution offers a safe and effective adjunctive treatment for urate stones in children.