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The aetiological and clinical pattern of childhood urolithiasis in Saudi Arabia
S A Al-Rasheed1, S R el-Faqih, I Husain
1Department of Paediatrics, King Khalid University Hospital, Riyadh, Saudi Arabia.
Insights
Pediatric kidney stones are common in Riyadh, with calcium oxalate and uric acid being the most frequent types. Treatment success rates are high with various interventions, though some cases have underlying metabolic or anatomical causes.
Area of Science:
- Nephrology
- Urology
- Pediatric Nephrology
Background:
- Kidney stones (nephrolithiasis) in children are a growing concern with diverse etiologies.
- Understanding the clinical and etiological patterns is crucial for effective management in pediatric populations.
Purpose of the Study:
- To review the clinical and etiological characteristics of kidney stones in 85 children treated at a nephrourological service in Riyadh.
- To analyze stone composition, predisposing factors, and treatment outcomes.
Main Methods:
- Retrospective review of 85 pediatric patients (under 15 years) with kidney stones.
- Analysis of stone composition, patient history, investigations (metabolic defects, anatomical anomalies, urinary tract infections), and treatment modalities.
Main Results:
- The male to female ratio was 2:1. Upper tract stones were predominant, with 12 bilateral cases.
- Calcium oxalate and uric acid/urate comprised one-third of analyzed stones each; 4 had cysteine stones, and 6 were struvite (infection-related).
- Successful treatments included extracorporeal shock wave lithotripsy (55 patients), surgery (16), and endourological procedures (7). Nine children had metabolic defects, 10 anatomical anomalies, and 15 urinary tract infections. Idiopathic disease accounted for 60%.
Conclusions:
- The study highlights the varied clinical and etiological landscape of pediatric kidney stones in Riyadh.
- A significant proportion of cases are idiopathic, emphasizing the need for thorough investigation for metabolic defects, anatomical anomalies, and infections.
Abstract:
The clinical and aetiological pattern in 85 stone-forming children presenting to an integrated nephrourological service in Riyadh is reviewed. All patients were below the age of 15 years, the male to female ratio being 2:1. Only 2 children presented with bladder calculi. The remaining all had upper tract stones and, in 12 cases, these were bilateral. Of 34 calculi recovered for analysis, one-third was predominantly calcium oxalate and a further third was composed of uric acid or urate. Four patients had cysteine stones and the remaining 7 presented mixed calcium stones, 6 (17.6%) being struvite and infection-related. Of the 85 patients 55 were treated successfully with extracorporeal shock wave lithotripsy, 16 underwent surgery and 7 had their stones removed by endourological procedures. In the remaining 7 children, stones dissolved or were passed spontaneously during medical therapy. Nine children (10.6%) showed a primary metabolic defect leading to their stone formation, 10 (11.8%) had a predisposing anatomical anomaly and 15 (17.6%) presented with urinary tract infection. Of the remaining 51 patients (60%) with idiopathic disease, 6 showed hypercalciuria on investigation and 2 children may have formed their stones due to prolonged recumbency.