Calculus anuria: A urological emergency with an excellent outcome. A retrospective review of pediatric population from a stone belt country, Pakistan

Abstract

Calculus anuria is a catastrophic condition with dire consequences if not treated promptly. The purpose of this study was to identify factors which influence the short-term outcome of patients with calculus anuria. A retrospective analysis was conducted from January 2016 to December 2021, in children up to the age of 18 years, who presented with calculus anuria and required emergency decompression at Sindh Institute of Urology and Transplantation, Pakistan. One hundred and twenty-five children were included. Majority were born to consanguineous parents and a few of them had positive family history of stone disease. Severe illness was found in 25 (20%) patients and among them 8 (32%) required hemodialysis. Decompression by double J stenting is the preferred intervention in our institute and was done in 106 (85%) of children followed by Percutaneous nephrostomy tube in 10 (8%) successfully. A small number of patients, 9 (7%) required both procedures to relieve their obstruction. A significant number of patients, about 115 (92%), attained normal renal functions after intervention. No pertinent factors were identified, relating to incomplete renal recovery in 9 (7%) of patients who unfortunately progressed to chronic kidney disease.

Assessment of CT-KUB as A Diagnostic Tool for Renal Stone Assessment in the Pediatric Population

“…Total stone patients in Pakistan are 10-15%. [1] Lying in the 'stone belt', the country poses multiple risk factors for stone formation, such as high ambient temperature, familial hyperoxaluria, and dehydration [2]. Certain regions in the country are 'endemic' for renal and bladder stones, especially in children.…”

Frequency of urinary metabolic abnormalities in children with renal stone disease.

“…8 The metabolic assessment of stone formers has been the subject of various studies in past; however, the bulk of these studies concentrate on adult populations and are limited by a lack of 24hour urinary metabolic screening, a lack of local data, and small sample sizes. 9 It has been seen that metabolic abnormalities that increase the risk of nephrolithiasis are identifiable in 75% to 84% of children. Common metabolic abnormalities in children with stone disease are; hypercalciuria (74.6%), hyperoxaluria (8.5-21%), hyperuricosuria (30.5%) and hypocitraturia (44-68 %) 10 Metabolic abnormalities were discovered in 22.8% of children with urinary lithiasis, according to a study conducted by Sajid MT in 2021.…”