Clinical and Biological Characteristics of Childhood Urolithiasis in Tunisia: A Study of 300 Cases

Background: Urolithiasis is a common disease in both developed and developing countries. over the past few decades, this pathological condition has become more common in children as a result of the rapid variations in dietary habits and the increasing standard of living. Objectives: Since the 1980s, the clinical and biological characteristics of urolithiasis in Tunisian children have been continuously evolving. This retrospective study defines the current status of urolithiasis among children and adolescents in Tunisia. Patients and Methods: Between 2003 and 2010, we retrospectively reviewed the records of 300 children and adolescents (age: 6 months to 19 years) with urolithiasis. A first-line metabolic, urine, and plasma work-ups were performed in all patients. Physical and chemical analyses of the stones were performed, respectively, by stereomicroscopy and infrared spectroscopy. Statistical analysis of the results was performed using SPSS 11.0 software. Chi-square test was used for comparing the percentages. Results: our study shows male predominance of urolithiasis with a male/female ratio of 1.54/1. Stones were located in the upper urinary tract in 69.0% of cases, and calcium oxalate was the predominant constituent in 53.0% of stones. The prevalence of calcium oxalate stones increased with age in both genders (48.5% in infants vs 67.9% in teenagers [P < 0.01]). Struvite stones were most commonly detected in patients aged 2 to 9 years (P < 0.02), and they were significantly more prevalent in boys than in girls (P < 0.001). Ammonium urate stones were observed in 14.0% cases, and were more commonly detected in infants. Conclusions: our results suggest a high percentage of calcium oxalate stones and a low percentage of struvite stones in infants. hence, patient age is an important factor that must be taken into account during etiopathogenic work-up of urolithiasis.