Pediatric Urolithiasis in Sub&amp;ndash;Saharan Africa: A Comparative Study in Two Regions of Cameroon

Angwafo, Fru; Daudon, Michel; Wonkam, Ambroise; Kuwong, Patrick M.; Kropp, Kenneth Α.

doi:10.1159/000020109

Cited by 31 publications

(16 citation statements)

References 20 publications

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“…Although stone location in our patients was similar to that in studies performed in developed countries [5,7,13,15], studies in developing countries have revealed the predominance of endemic bladder calculi [4,17,18,19]; their occurrence is thought to be linked to malnutrition and sociocultural factors common in these regions [1,2,3,20]. The presence of multiple sites for stone location and/or multiple stones in children should arouse strong suspicion of metabolic disorders [17], this observation was supported by our results.…”

Section: Discussionsupporting

confidence: 85%

“…Anatomical defects contributed little. Different etiological patterns of pediatric UL have been observed in different regions [2,4,7,13,14,15,16,17,18,22]. These variations might be explained by different socioeconomic, environmental, genetic, and dietary factors [4,14].…”

Section: Discussionmentioning

confidence: 99%

“…A recent study from Armenia reported 9% of endemic bladder calculi [12]. Rates in the tropics are higher [4,16,19,18,20]. Their formation depends mainly on the composition of urine, which in turn reflects the type of diet consumed [6].…”

Section: Discussionmentioning

confidence: 99%

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Etiological and clinical patterns of childhood urolithiasis in Iraq

Ali

Rifat

2005

Pediatr Nephrol

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This study was conducted to evaluate the etiological and clinical characteristics of urolithiasis in Iraqi children. From 1999 to 2004, 204 children with renal calculi were evaluated. The age range of the patients was 4 months to 14 years, 61.3% of the patients were under 5 years. Male to female ratio was 2.8:1. The mean age at onset of symptoms was 3.2 years, and stone disease was diagnosed at a mean of 3.5 years. Hematuria (44.6%) and pain (28.4%) were the main clinical presentation. Of the 204 patients 45.1% had a family history of stones. Consanguinity was recorded in 72%; 75.5% had metabolic disorders. Stones were located at multiple sites in 80 patients, or 39.2%; 58 of these 80, or 72.5%, had metabolic disorders. Multiple stones were present in 47 (23%); 72.3% were related to metabolic disorders. In 126 patients, or 61.8%, both kidneys were involved equally. Bladder stones were found in 11.3%. Staghorn calculi occurred in 29 patients, or 14.2%; 27 of these had recurrent urinary tract infection (UTI). Nephrocalcinosis was diagnosed in 7, or 3.4%; all had metabolic disorders. Etiology of stone formation was established in 189 patients, or 92.6%, whereas 15, or 7.4%, had idiopathic stones. Metabolic disorders were the commonest cause in 106 patients (52%); 52 patients were classified as infective (25.5%). Anatomical defects were present in 25 (12.2%) and 6 children (2.9%) with primary endemic bladder calculi. Coexisting UTI was common (36.8%) in the metabolic group. We concluded that urolithiasis is a serious problem among Iraqi children, with early onset of presentation. Metabolic disorders were the major causes, but can be masked by associated UTI. Proper management of UTI with a careful metabolic assessment of young stone formers is valuable in combating urolithiasis.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

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Etiological and clinical patterns of childhood urolithiasis in Iraq

Ali

Rifat

2005

Pediatr Nephrol

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“…Bladder AAU calculi in children have also been reported from Asia, the Middle East, and Africa. [2][3][4] The formation of AAU crystals is thought to be related to an acidic purine-rich and phosphorus-poor diet combined with a low fluid intake and frequent diarrhea, which promotes urine that is highly concentrated in uric acid and ammonium. 9 In developed countries, AAU-containing urolithiasis have been described in association with laxative abuse, chronic bowel disease, and anorexia nervosa.…”

Section: Discussionmentioning

confidence: 99%

Ammonium acid urate urolithiasis in Japan

Kuruma

Arakawa

Kubo³

et al. 2006

Int J of Urology

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Aim: Ammonium acid urate (AAU) calculi are a rare urolithiasis in developed countries but are endemic in developing countries. We assessed the features of AAU urolithiasis in Japanese patients. Methods: We reviewed hospital charts of patients with urolithiasis who were treated with extracorporeal shock wave lithotripsy and endourological procedures at Sagamidai Hospital (Kanagawa, Japan) from January 1992 to December 2001. On the basis of the results of stone analysis with an infrared spectrophotometer, AAU stones were found. Results: Of 8664 urolithiasis that we reviewed, 33 calculi (0.38%) from 29 patients contained AAU crystals. From crystallographic findings, we defined two types of AAU-containing stones: pure and mixed AAU urolithiasis. Pure AAU urolithiasis were seen in 13 stones from 10 patients and mixed AAU in 20 stones from 19 patients. We found significant differences between the groups: the pure AAU group predominantly consisted of young, thin women and the mixed group consisted of middle-aged men. Laboratory findings showed trends of low levels of serum protein, potassium, and urine pH in the pure AAU group. Conclusions: Because each type of AAU urolithiasis is associated with different patient characteristics and pathophysiological features, it is important to understand the type of AAU urolithiasis in patients with calculi.

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“…This drop caused by the weak of bladder stones frequency (3-4%) [31,32]. Whereas it remains prevalent in rural areas of developing countries [33][34][35].…”

Section: Discussionmentioning

confidence: 99%

Changes in stone composition according to age in Tunisian pediatric patients

2009

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The epidemiology of renal stones has changed all over the world toward a predominance of calcium oxalate stones. However, studies evaluating the influence of age and gender on the distribution of the various types of urinary calculi are scarce. We will present the results of a study based on 205 calculi (from 122 boys and 83 girls) analyzed by infrared spectroscopy between 1993 and 2007. 90% of stones were collected by surgery, whereas only 6% by spontaneous passage. The biological exploration was performed in only 126 cases. Etiology was metabolic in 13.5%. 10.7% of stones were infectious, 13.1% were endemic and 54.9% were idiopathic. 7.8% were secondary to urinary stasis with malformation but no infection. Calcium oxalate (CaOx) was the predominant constituent in 54.7% of stones, followed by calcium phosphate and purines 14.6% in each of the cases. We found an increasing prevalence of calcium oxalate stones with age in both genders (42.9% in infant vs. 59.3% in child) (P < 0.05). Struvite stones were more frequent in infant than children. Purine stones were predominant in 20% of cases, but its prevalence decreases with age. The increase in calcium oxalate stone in school age children and the decrease in struvite and purine stones confirm the change on the etiology of urolithiasis according to age.

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Pediatric Urolithiasis in Sub–Saharan Africa: A Comparative Study in Two Regions of Cameroon

Cited by 31 publications

References 20 publications

Etiological and clinical patterns of childhood urolithiasis in Iraq

Etiological and clinical patterns of childhood urolithiasis in Iraq

Ammonium acid urate urolithiasis in Japan

Changes in stone composition according to age in Tunisian pediatric patients

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