Paediatric Urolithiasis an Emerging Concern: Single Centre Experience in a Non-Endemic Region in South India
DOI:
https://doi.org/10.17140/UAOJ-5-136Keywords:
Paediatrics, Urolithiasis, Urinary tract infection (UTI), aetiology, paediatric stone diseaseAbstract
Introduction
Paediatric urolithiasis is an emerging disease in developing nations especially in India, but a rarer entity compared to its adult counterpart. There is significant geographic variation in the incidence of urolithiasis within India itself. Given the changing dynamics of
the disease, this study evaluated paediatric urolithiasis patients in a non-endemic region in South India.
Methods
This is a retrospective study of children and adolescents diagnosed with urolithiasis from January 2009 to December 2019 in a
single tertiary care centre in South India. The purpose of this study was to investigate and identify the demographic and clinical
characteristics, aetiology, management, clearance rates after surgical intervention and disease recurrence of paediatric stone disease
in a non-endemic region in South India.
Results
We evaluated 29 patients which included a total of 97 hospital admissions. Predominantly the study population consisted of males
(80.0%), with a mean age of symptom onset of 9.44±5.53-years. All patients were metabolically evaluated, 16 patients (55.2%) had
metabolic abnormalities and the most common abnormality was hypocitraturia (37.5%). Spontaneous elimination rate was 6.9%
and clearance rates for surgical procedures ranged from 72% to 100%. Recurrent stones were seen in 37.9%. No patient developed
chronic kidney disease or mortality due to stone disease within the evaluation period of this study.
Conclusion
Paediatric urolithiasis is an emerging disease in India. There is a high prevalence of metabolic abnormalities in paediatric stone
disease which supports the need for metabolic evaluation in all cases. There is more similarity of our study with western literature
than the available Indian data which may be due to the lifestyle changes, significant geographic variation within India itself between
endemic and non-endemic regions or changing epidemiology of paediatric stone disease perse.
References
Edvardsson V. Urolithiasis in children. In: Pediatric Nephrology. 7th ed. Heidelberg, Germany: Springer Berlin Heidelberg; 2016: 1821- 1868. doi: 10.1007/978-3-662-43596-0_53
Gajengi AKR, Wagaskar VG, Tanwar HV, Mhaske S, Patwardhan SK. Metabolic evaluation in paediatric urolithiasis: A 4-year open prospective study. J Clin Diagnostic Res. 2016; 10(2): PC04-PC06. doi: 10.7860/JCDR/2016/17265.7251
Rizvi SAH, Sultan S, Zafar MN, Ahmed B, Aba Umer S, Naqvi SAA. Paediatric urolithiasis in emerging economies. Int J Surg. 2016; 36: 705-712. doi: 10.1016/j.ijsu.2016.11.085
Amancio L, Fedrizzi M, Bresolin NL, Penido MGMG. Pediatric urolithiasis: experience at a tertiary care pediatric hospital. J Bras Nefrol. 2016; 38(1): 90-98. doi: 10.5935/0101-2800.20160014
Rellum DM, Feitz WF, Van Herwaarden AE, Schreuder MF. Pediatric urolithiasis in a non-endemic country: A single center experience from the Netherlands. J Pediatr Urol. 2014;10: 155-161. doi: 10.1016/j.jpurol.2013.07.019
Rizvi SAH, Naqvi SAA, Hussain Z, Hashmi A, Hussain M, Zafar MN, et al. Pediatric urolithiasis: Developing nation perspectives. J Urol. 2002;168: 1522-1525. doi: 10.1097/01. ju.0000028601.63446.51
Moreira Guimarães Penido MG, de Sousa Tavares M. Pediatric primary urolithiasis: Symptoms, medical management and prevention strategies. World J Nephrol. 2015; 4(4): 444-454. doi: 10.5527/wjn.v4.i4.444
Naseri M, Varasteh AR, Alamdaran SA. Metabolic factors associated with urinary calculi in children. Iran J Kidney Dis. 2010; 4(1): 32-38.
Van Dervoort K, Wiesen J, Frank R, Vento S, Crosby V, Chandra M, et al. Urolithiasis in pediatric patients: A single center study of incidence, clinical presentation and outcome. J Urol. 2007; 177(6): 2300-2305. doi: 10.1016/j.juro.2007.02.002
Kroovand RL. Pediatric urolithiasis. Urol Clin North Am. 1997; 24: 173-184. doi: 10.1016/s0094-0143(05)70362-1
Kit LC, Filler G, Pike J, Leonard MP. Pediatric urolithiasis: Submit your article to this journal | https://openventio.org/submit-manuscript/ Experience at a tertiary care pediatric hospital. J Can Urol Assoc. 2008; 2(4): 381-386. doi: 10.5489/cuaj.804
Bak M, Ural R, Agin H, Serdaroglu E, Calkavur S. The metabolic etiology of urolithiasis in Turkish children. Int Urol Nephrol. 2009; 41(3): 453-460. doi: 10.1007/s11255-008-9513-x
Coward RJM, Peters CJ, Duffy PG, Corry D, Kellett MJ, Choong S, et al. Epidemiology of paediatric renal stone disease in the UK. Arch Dis Child. 2003; 88: 962-965. doi: 10.1136/adc.88.11.962
Alpay H, Ozen A, Gokce I, Biyikli N. Clinical and metabolic features of urolithiasis and microlithiasis in children. Pediatr Nephrol. 2009; 24: 2203-2209. doi: 10.1007/s00467-009-1231-9
Van Savage JG, Palanca LG, Andersen RD, Rao GS, Slaughenhoupt BL. Treatment of distal ureteral stones in children: Similarities to the American Urological Association guidelines in adults. J Urol. 2000; 164(3 II): 1089-1093. doi: 10.1097/00005392- 200009020-00043
Pietrow PK, Pope IV JC, Adams MC, Shyr Y, Brock JW. Clinical outcome of pediatric stone disease. J Urol. 2002; 167(2 I): 670-673. doi: 10.1097/00005392-200202000-00060
Koyuncu H, Yencilek F, Erturhan S, Eryildirım B, Sarica K. Clinical course of pediatric urolithiasis: Follow-up data in a long-term basis. Int Urol Nephrol. 2011; 43(1): 7-13. doi: 10.1007/s11255- 010-9791-y
Hari P, Bagga A, Vasudev V, Singh M, Srivastava RN. Aetiology of nephrolithiasis in north Indian children. Pediatr Nephrol. 1995; 9(4): 474-475. doi: 10.1007/BF00866731
Bakane BC, Nagtilak SB, Patil B. Urolithiasis : A tribal scenario. Indian J Pediatr. 1999; 66(6): 863-865. doi: 10.1007/BF02723855
Shah AM, Kalmunkar S, Punekar S V, Billimoria FR, Bapat SD, Deshmukh SS. Spectrum of pediatric urolithiasis in western India. Indian J Pediatr. 1991; 58(4): 543-549. doi: 10.1007/BF02750939
Downloads
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution 4.0 International License.
All content published in Urology and Andrology (UA) is licensed under the Creative Commons Attribution 4.0 International License (CC BY 4.0). This license allows anyone to copy, distribute, transmit, and adapt the work — including for commercial purposes — provided appropriate credit is given to the original author(s) and source.
