Year : 2007 | Volume
: 23 | Issue : 4 | Page : 420--427
Evaluation of children with urolithiasis
Syed A.H Rizvi1, Sajid Sultan1, Mirza N Zafar2, Bashir Ahmed1, Syed M Faiq3, Kehkashan Z Hossain4, Syed A.A Naqvi1
1 Department of Urology, Sindh Institution of Urology and Transplantation, Civil Hospital, Karachi - 74200, Pakistan
2 Department of Pathology, Sindh Institution of Urology and Transplantation, Civil Hospital, Karachi - 74200, Pakistan
3 Department of Radiology, Sindh Institution of Urology and Transplantation, Civil Hospital, Karachi - 74200, Pakistan
4 Department of Nutrition, Sindh Institution of Urology and Transplantation, Civil Hospital, Karachi - 74200, Pakistan
Objectives: To describe an evaluation protocol for pediatric stone formers for risk assessment and management strategies.
Materials and Methods: Between 2002-2006, 2618 children of age three months to 15 years were evaluated for stone disease. Evaluation included demographics, history, anthropometry, diet, ultrasound, X-ray KUB, IVU, blood and 24h urine chemistry and cultures. Stones were analyzed by IR spectroscopy.
Results: The median age was seven years with a M:F ratio of 2.2:1. Of the 2618 patients, 2216 presented with normal renal function and 402 with renal failure. Main symptoms were abdominal pain (33%), flank pain (38%) and fever (38%). Renal failure patients also had shortness of breath (38%) and oligo-anuria (26%). Children were malnourished with height and weight deficits in 65% and 76% respectively. Diet was low in protein (74%), calcium (55%) and fluids in (55%), high in oxalate (55%), sodium (39%), purines (42%) and refined sugar (41%). Overall urine cultures were positive in 1208 (46%) with E. coli (38%) and Klebsiella (8%).
Stone distribution was renal in 64%, ureter in 8%, bladder in 18%, bilateral in 40% and multiple sites in 18%. Median stone size was >1.5-2.0 cm. The frequency of compounds in stones was ammonium urate (58%), calcium oxalate (63%), uric acid (6%), calcium phosphate (12%) and struvite (8%). Metabolic abnormalities included hypovolumia (31%), hypocitraturia (87%), hyperoxaluria (43%) and hyperuricosuria (26%). Dietary and medical treatment corrected risk factors in two-thirds of patients with a recurrence rate of about 1.15%.
Conclusion: An evaluation based on history, imaging, diet, metabolic analysis and stone type can help to tailor management strategies.
Syed A.A Naqvi
Department of Urology, Sindh Institute of Urology and Transplantation, Civil Hospital, Karachi - 74200
|How to cite this article:|
Rizvi SA, Sultan S, Zafar MN, Ahmed B, Faiq SM, Hossain KZ, Naqvi SA. Evaluation of children with urolithiasis.Indian J Urol 2007;23:420-427
|How to cite this URL:|
Rizvi SA, Sultan S, Zafar MN, Ahmed B, Faiq SM, Hossain KZ, Naqvi SA. Evaluation of children with urolithiasis. Indian J Urol [serial online] 2007 [cited 2021 Sep 17 ];23:420-427
Available from: https://www.indianjurol.com/article.asp?issn=0970-1591;year=2007;volume=23;issue=4;spage=420;epage=427;aulast=Rizvi;type=0