Retrospective evaluation of children with urinary tract stone disease

Objective: Our country is among the endemic countries in terms of urinary tract stone disease (urolithiasis). In this study, we aimed to evaluate the demographic and clinical features of children who were followed because of urolithiasis, and also to determine the etiology of stone disease, diagnosis and treatment options. Materials and Methods: A hundred sixty seven children with the diagnosis of urolithiasis, followed in Pediatric Nephrology and General Pediatric Outpatient Clinics of Gaziantep University Hospital, between the years of 2010 to 2015. The age, sex, complaints in admission, breast milk intake, usage of vitamin D, history of recurrent urinary tract infection, relativity between parents, history of urinary tract stone disease in family members and first degree relatives, physical examination and laboratory findings (blood urea nitrogen, creatinine (crea), uric acid, magnesium (Mg), calcium (Ca), phosphorus, alkaline phosphatase, parathyroid hormone, vitamin D levels, urine examination, blood gase, spot urine Ca / crea, uric acid / crea, Mg / crea ratios, oxalate, citrate, and cystine levels, stone analysis (if there is), as well as routine ultrasonographical evaluation, direct urinary system graphy, intravenous urography, voiding cystourethrographie, static and dynamic renal scintigraphy imaging results, and treatment options were analyzed retrospectively. Results: The mean age of 167 patients (92 male, 75 female) enrolled to the study was 30.30 ± 42.60 months, and 41.9% (n = 70) had a family history of urolithiasis. The most common complaints in symptomatic patients were restlessness (34.4%), abdominal pain (15.6%), detection of stone in renal ultrasonography (9.1%) and macroscopic hematuria (7.1%), respectively. It has been observed that 58.1% of patients in the study group had at least one or more structural or metabolic predisposing factors leading to stone formation. Stone analysis was performed on 13.7% of cases and 65% of these patients had calcium oxalate stone formers. The most common metabolic risk factors were hypocitraturia (55.1%), hypomagnesuria (47.9%), and hypercalcuria (12.6%), respectively. Diet, increased fluid intake and salt restriction had been suggested to all patients, while 19.2% of them had surgical treatment for stones, and 54.4% received medical treatment according to the underlying metabolic problem. Conclusion: Urolithiasis continues to be one of the major health problems including pediatric age group. Metabolic evaluation and the identification of anatomical abnormalities is essential, especially in children to prevent the recurrence of stones and kidney damage. Keywords: Children, hypocitraturia, urinary tract stone disease, urolithiasis