Metabolic stone composition in Egyptian children.
OBJECTIVE
The composition of urinary stones in children depends on socioeconomic conditions, geography and dietary habits. Pediatric urolithiasis remains endemic in developing countries. The aim of this study was to analyze stone composition in an Egyptian patient population.


METHODS
We analyzed prospectively urinary stones from 100 consecutive children (73 males, 27 females), aged 14 months to 12 years. The stones were located in the upper urinary tract in 78%, lower urinary tract in 19% and both in 3%. Male patients had more lower urinary tract stones. On presentation 67% had flank pain and 37% had hematuria. Stones were treated by open surgery in 69% of patients, shockwave lithotripsy in 20% and endoscopic extraction in 13%.


RESULTS
The components of the upper urinary tract calculi were calcium oxalate (47%), ammonium acid urate (26%) and calcium carbonate (21%), whereas the main components of the lower urinary tract calculi were ammonium acid urate (27.2%), struvite (27.2%) and calcium carbonate (22.7%). Urinary tract infection was involved in the development of one third of the stones. Endemic stones were present in 17% of patients, and stones of metabolic origin in 15%. The etiology of stone formation remained unknown in one third of patients.


CONCLUSIONS
The epidemiological profile of urinary stones in Egyptian children can now be considered intermediate between developing countries where dietary deficiencies are the main causes and developed countries where infectious and metabolic calculi are observed.
Aggour
Ashraf
A
Department of Urology, Aboul-Riche Children's Hospital, Cairo University, Cairo, Egypt.
Ziada
Ali M
AM
AbdelHamid
Ahmad Z
AZ
AbdelRahman
Sherif
S
Morsi
Ahmad
A
D002119:Calcium Carbonate / Q000378:metabolism; D002129:Calcium Oxalate / Q000378:metabolism*; D002130:Calcium Phosphates / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D004534:Egypt / Q000453:epidemiology; D005260:Female; D006801:Humans; D007223:Infant; D008096:Lithotripsy / Q000706:statistics & numerical data; D017616:Magnesium Compounds / Q000378:metabolism; D008297:Male; D010710:Phosphates / Q000378:metabolism; D011446:Prospective Studies; D017678:Sex Distribution; D000069877:Struvite; D014527:Uric Acid / Q000378:metabolism; D014545:Urinary Calculi / Q000453:epidemiology* / Q000378:metabolism* / Q000601:surgery / Q000628:therapy; D014552:Urinary Tract Infections / Q000453:epidemiology*; D013520:Urologic Surgical Procedures / Q000706:statistics & numerical data
D002130:Calcium Phosphates; D017616:Magnesium Compounds; D010710:Phosphates; D002129:Calcium Oxalate; D014527:Uric Acid; C020243:calcium phosphate; D000069877:Struvite; D002119:Calcium Carbonate