Clinical presentation, etiological factors, and outcome in children diagnosed with urolithiasis in Ghaziabad, Uttar Pradesh

Abstract

Background: Children with urolithiasis (UL) are often encountered in general pediatric practice. Its rising incidence, high recurrence rate, serious long-term consequences, and paucity of data on pediatric UL led to the present research work. Recurrence usually remains unaltered unless dietary restrictions are followed stringently, so the emphasis in the present research was on the analysis of the diet consumed by participants. Materials and Methods: Children with UL were enrolled from the general pediatrics outpatient department of an urban hospital over 22 months in a prospective study. Data were collected on clinical profile, 24 h dietary details, blood and urine investigations, and ultrasound (USG) abdomen. Attempts were made to get basic metabolic work-up in as many children as possible. Results: Abdominal pain alone or with symptoms of urinary tract infection (UTI) was found in 40 (83.3%) and 22 (45.8%) participants. Important etiological associations found were UTI (30, 62.7%), positive family history of UL (22, 45.8%), and obesity (5, 10.4%). Idiopathic hypercalciuria, hyperuricosuria, and hyperoxaluria were found in 9 (18.7%), 2 (4.2%), and 12 (25%) participants. Daily intake of liquids and calcium was low in 38 (79%) and 35 (72.9%) children, respectively. Intake of both salt and proteins was high in 30 (62.5%) children. The persistence of symptoms was found in 28 (58.3%) participants. Recurrence was found in 7 (14.5%) participants. Conclusion: Having a high index of suspicion of UL in all children presenting with recurrent unexplained UTI and/or recurrent abdominal pain and advocating USG abdomen early in such children can aid in the timely diagnosis of UL. Simple dietary manipulations such as adequate daily fluid and calcium intake along with avoiding high salt and animal protein diet may be beneficial by decreasing the recurrence rate of UL.