title: Metabolic Evaluation in Paediatric Urolithiasis: A 4-Year Open Prospective Study.
abstract: BACKGROUND
  Children with urolithiasis are associated with considerable morbidity and commonly associated with metabolic abnormalities. By treating these abnormalities stone formation is prevented.
  
  
  OBJECTIVE
  To study the metabolic risk factors of urolithiasis in children and compare them with literature.
  
  
  METHODS
  In open, prospective and observational study, 75 children were evaluated from August 2010 to June 2014. In all patients' dietary history, water intake and results of laboratory findings were recorded. All urine samples obtained from patients were without dietary restrictions. Reference paediatric 24 hour urinary parameter was used according to western literature.
  
  
  RESULTS
  We investigated 75 patients with urolithiasis. Low urine volume was found in 49 patients which is comparable with previous studies indicating simple intervention as to increase water intake. Low calcium intake was found in 44 patients suggesting that low calcium intake is associated with higher incidence of urolithiasis due to increased intestinal oxalate absorption. Hypocalcaemia was found in 32 patients and 24 hour urinary abnormality was found in only 16 patients'. Both these finding does not support previous literature. Stone analysis finding does not correlate with urinary finding.
  
  
  CONCLUSIONS
  Low urine volume secondary to low water intake is predominant finding. Hypocalcaemia is major metabolic abnormality in contradiction to western literature. There are no nomograms for urinary excretion of Calcium, uric acid, oxalate and citrate in Indian children. Keeping the optimum blood calcium level & increased fluid intake can prevent stone formation in children.
authors.affiliation: Senior Resident, Department of Urology, Seth G.S.M.C. and King's Edward Memorial Hospital , Mumbai, Maharashtra, India .
authors.forename: Ajay Kumar R
authors.initials: AK
authors.lastname: Gajengi
authors.affiliation: Senior Resident, Department of Urology, Seth G.S.M.C. and King's Edward Memorial Hospital , Mumbai, Maharashtra, India .
authors.forename: Vinayak Gorakhnath
authors.initials: VG
authors.lastname: Wagaskar
authors.affiliation: Senior Resident, Department of Urology, Seth G.S.M.C. and King's Edward Memorial Hospital , Mumbai, Maharashtra, India .
authors.forename: Harshwardhan V
authors.initials: HV
authors.lastname: Tanwar
authors.affiliation: Senior Resident, Department of Urology, Seth G.S.M.C. and King's Edward Memorial Hospital , Mumbai, Maharashtra, India .
authors.forename: Sunil
authors.initials: S
authors.lastname: Mhaske
authors.affiliation: Professor and Head, Department of Urology, Seth G.S.M.C. and King's Edward Memorial Hospital , Mumbai, Maharashtra, India .
authors.forename: Sujata K
authors.initials: SK
authors.lastname: Patwardhan
keywords: Hypercalciuria; Hypocalcaemia; Urinary tract infections; Urine volume