A study of urolithiasis in children admitted to a tertiary care hospital

Background: Paediatric urolithiasis is now commoner and is associated with a high risk of recurrence and an increased morbidity. Objectives: To study the clinical profile, the metabolic and anatomical risk factors predisposing to urolithiasis in children admitted to a tertiary care hospital. Method: The study included children between 1 month and 18 years of age admitted in tertiary care with a diagnosis of urolithiasis. A detailed history, including demographic data, physical examination, laboratory parameters, imaging studies, 24 hour urine for metabolic workup were noted, Stone was sent for analysis of composition. The study period was from 2012 to 2017. Results: The study group consisted of 56 children with a median age at onset of symptoms of 8.1 years. The common presenting symptoms were abdominal pain (87.5%) and fever (30.4%). Anatomical defects were associated with urolithiasis in 9 (16.1%) children. Hypocitraturia was observed in 34 (63.1%) children followed by hyperoxaluria in 20 (37%) children. Hypercalciuria was observed in 8 (14.8%) children. Majority (71.5%) of calculi were in the kidney and were constituted by calcium oxalate (75%). At follow up, 10 (22.2%) children had persisting calculi, 7 (15.5%) had a recurrence and in the remaining 28 (62.2%) children no recurrence was observed. Conclusions: Abdominal pain was the presenting symptom in 87.5% cases. Hypocitraturia was observed in 63.1% cases. Majority (71.5%) of calculi were in the kidney. There were recurrent calculi in 15.5%.