Prevalence and risk factors of Urolithiasis among children age less than 14 years in Tikur Anbessa Teaching Hospital, Addis Ababa, Ethiopia

Abstract

Background: - Urolithiasis in the pediatric age group plays an important urologic problem, not only in parts of the world with a high incidence of stone disease such as the near and Far East, but also in the developing and industrialized countries. Pediatric urolithiasis is associated with significant morbidity, particularly recurrent stones as well as the development and progression of renal dysfunction, thus, should not be underestimated. This study will assess the prevalence and risk factors for urolithiasis in children in a tertiary teaching hospital.
Objectives: To assesses the prevalence and risk factors of urolithiasis, in children whose age is less than 14 years in Tikur Anbessa Specialized Teaching Hospital.
Materials and methods: This is a retrospective cohort study conducted in admitted patients with the diagnosis of urolithiasis in Tikur Anbessa Specialized Teaching Hospital over an eight year period from 2002 to 2010 GC. Data was collected from the records of patients.
Result: A total of 63 children with urolithiasis were admitted to Tikur Anbessa Specialized Teaching Hospital over an eight year period. This accounts to 1 in 121 (0.83%) pediatric surgical ward admissions annually. Among those half of the patients (54%) were in the age range between 5-10 years and 85.7% were males. The major clinical symptoms at first presentation were hematuria (63.5%) recurrent urinary tract infection (60.3%), obstructive symptoms (46.0%), flank pain (42.9%) and family history of urolithiasis was preset in (3.2%). Urine culture was done for 38.1% of the children and 25% of them were positive for E.coli or Klebsiella pneumoniae. Pyuria was present in 47.6% of children. All the stones were visualized by ultrasound, almost half of the stones were found in
the kidneys (53.9%) and bladder (39.7%). Ureteric stones constituted 6.3%. Sixty six point seven percent of the stones were removed surgically and 19.0% passed spontaneously. Extracorporeal Shock Wave Lithotripsy (ECSWL) was used in 14.3% of children. Stone analysis result was found in 15/63 (23.8%) children and Calcium oxalate was the commonest stone constituting 40%, uric acid 13.3%, calcium oxalate and uric acid(20%),and 26.6% were more than 2 types (mixed) stones. There was recurrence of stone in 9.5% of children and 50% recurred after one year of follow up.
Conclusion: Even though the prevalence of urolithiasis in children is low it is not uncommon to see complications like recurrence and renal insufficiency. Any child who presents with hematuria and recurrent urinary tract infection, stone disease has to be ruled out. All stones have to be analyzed and children with stone disease have to be followed even after removal.