Rab Nawaz, Umairul Islam, Nayyerul Islam.
Urolithiasis in children in Pakistan.
Med Channel Jan ;13(2):45-9.

Urolithiasis in children is an important urological problem in Pakistan. In developing countries urinary bladder stones are endemic, and are found to be linked to socio-economic conditions, diet and nutritional status of the population. Little data is available on the causative factors for renal calculi in children in Pakistan. Kidney stones may recur after surgery and can be prevented with adequate management. AIMS OF THE STUDY: I. To study clinical presentation of urolithiasis in children. 2. To determine factors, responsible for urolithiasis. 3. To study the type of stones commonly seen in children. DESIGN OF STUDY: This was a descriptive study conducted in Nephrology Unit of National institute of child Health, Karachi from March 1995 to March 1996. STUDY POPULATION: 67 patients were included in the study. Age ranged between 0 to 15 years. Both sexes were included in the study. The detailed history including family history, history of recurrent urolithiasis, and history of diarrhea were taken. Investigations included radio-imagine, Urine D/R was done to detennine pH and crystals. Metabolic screening included serum calcium, electrolytes, uric acid, bicarbonate and 24 hours urinary calcium, oxalate, citrate and creatinine. Stone analysis was done in all cases. RESULTS: A total of 67 patients were included in this study. Male to female ratio was 3.2:1. Family history of stone disease was found to be positive in 21 (31%) patients, whereas recurrence of stones was seen in 26 (38%). History of repeated attacks of diarrheoa was present in 14 (21%). Commonest presentation was dysuria (70%) followed by abdominal pain (58.5%) and haematuria (55%). Factors found to be associated included: congenital urinary tract anomalies ( I I cases), hypocitraturia (6 cases), idiopathic hypercalciuria (5 cases), nephrocalcinosis (5 cases), urinary tract infection (6 cases). Endemic urinary bladder stones were seen in 23 patients while idiopathic calcium oxalate stones were found in 10. common types of stones were mixed calcium oxalate and urate and phosphates (43%), calcium oxalate (39%), uric acid and struvite stones seen were 9% of cases respectively. CONCLUSION: Urolithiasis in children in Pakistan is found to be associated with (1) Malformalities of urinary tract. (2) Urinary tract infections. (3) Metabolic abnormalities.

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