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.