Metabolic evaluation of children with urolithiasis

Abstract

Aim:The aim of the study is to identify the prevalence of metabolic abnormalities in children with urolithiasis.Materials and Methods:This is a prospective study; all children below 15 years who are found to have urolithiasis were prospectively evaluated with relevant history, clinical examination, and urine and serum testing. Metabolic workup includes complete urine examination, urine culture and sensitivity, and 24-h urinary analysis (lithorisk profile).Results:A total of 55 patients are included in the study. Forty-two are boys and 13 are girls aged between from 8 months to 15 years. Thirty-three patients underwent stone analysis, primary composition of calcium oxalate stones in 19 (58%), ammonium urate in 4, dahlite in 3 and uric acid in 3, silicon oxide in 2, and struvite in 2 cases. Lithorisk profile was performed in 40 cases (72.7%). The pH range is 5.6–6.2. We noted hypercalciuria in 20 patients (50%), hyperuricosuria in 23 (57.5%), hyperoxaluria in 20 (50%), hypernatriuria in 26 (65%), hypocitraturia in 9 (23%), and hypomagnesuria in 3 (7.5%). Urine calcium-to-creatinine ratio >0.2 was found in 22 (55%) patients. Statistically significant association between hyperoxaluria and hyperuricosuria (P < 0.04, r = 0.32) and hypercalciuria and hyperuricosuria (P < 0.001, r = 0.51) found in this study. Hyperuricosuria is seen in 75% and 73% of patients with hypercalciuria and hyperoxaluria, respectively. Twenty-five children have both lithorisk profile and stone analysis. Hypercalciuria and hyperoxaluria were noted in 60% of calcium oxalate stone formers each. Elevated urinary calcium/creatinine ratio (>0.2) was seen in 73% of calcium oxalate stone formers.Conclusion:Because of high prevalence of metabolic risk factors and the significant risk of lifelong recurrence, all children with urolithiasis need complete evaluation with metabolic workup.

Frequency of Metabolic Abnormalities in Pakistani Children With Renal Stones

“…In our study, the most common presenting feature was UTI, followed by flank or abdominal pain and hematuria. These results are consistent with those of other studies [13,28,29]. Both visible and non-visible hematuria were relatively uncommon in our study compared with other reports [15,19].…”

Relationship Between the ApaI (rs7975232), BsmI (rs1544410), FokI (rs2228570), and TaqI (rs731236) Variants in the Vitamin D Receptor Gene and Urolithiasis Susceptibility: An Updated Meta-Analysis and Trial Sequential Analysis

“…(Imamverdiev and Guseinzade, 2015). Studies have shown that hot conditions, reduced dietary fiber intake, and high intake of animal protein are important risk factors for urolithiasis (Gouru et al, 2018). There is a direct link between diet and urolithiasis, and studies have found that excessive intake of high-fat foods has a catalytic effect on the formation of urolithiasis (Shimizu et al, 2012).…”

Metabolic studies and calculi analysis in urinary lithiasis, how to stop recurrence?

“…Hypercalciuria (> 300 mg/day) is defined as an increase in urinary calcium excretion, independent on serum calcium levels 38 . While, 99% of the body's calcium stores is found in the skeleton, only 1% remains in the intra and extracellular spaces 39 .…”