Etiology of Urolithiasis in Children

Urinary stones are a common problem among children that causes pain, dysuria, and other complications, including urinary tract obstruction and infection. The prevalence of urinary stones in children has been increasing in recent decades. Since the causes of urolithiasis in children differ in various geographical regions, with diverse ethnic backgrounds and popular nutritional habits changing over time, we designed this study to update the identifiable etiologies of urinary stones in children younger than 14 years in Northwest Iran.

This cross-sectional study was conducted on 144 children with urinary stones who were referred to Tabriz Children’s Hospital, Tabriz City, Iran, from March 2018 to September 2020. To determine the main causes of urolithiasis, such as metabolic disorders, urinary tract infections, and anatomical abnormalities, several variables, including age, sex, and results of ultrasound examination, urine analysis and biochemical tests, urine culture, and blood gas analysis, were collected, analyzed, and interpreted.

In this study, 90 boys and 54 girls with an average age of 11.75 (ranged: 1-160) months were included. The most common causes of urolithiasis were metabolic or biochemical disorders in 67 cases (46.5%), mainly hypercalciuria followed by hyperoxaluria, anatomical abnormalities in 10 children (7%), and urinary tract infections in 3 patients (2.1%). Dehydration leading to excessive urine concentration in 87 children (60.4%) was the most common condition associated with urolithiasis in the studied children.

Regarding the high prevalence of metabolic disorders, especially hypercalciuria in children with urolithiasis, these disorders should be considered for preventive, diagnostic, and therapeutic measures.