Renal Data from the Arab World: Childhood urolithiasis in north-western Libya.

The study reviews causes of urolithiasis and its manifestations in North-West (NW) Libya. Libyan childhood urolithiasis accounted for 3.6% of nephrology out-patient work load. There were 59 children with urolithiasis,including 34 boys and 25 girls with a mean age of 2.8 ± 2.42 years. Urolithiasis was more common among younger age groups (P = 0.001) and in boys with primary oxaluria and infective etiology. The causes of urolithiasis included metabolic stones in 64%,infective in 26%,and it was idiopathic in 10%. Overall,family history of renal stone disease was elicited in 59%; it was 92% in patients with primary oxaluria. The main presenting features were abdominal pain (27%),gross hematuria (22%),associated urinary tract infection (UTI; 24%),and stone release in 19%. Stone location was bilateral in 64%,multiple in 68%,and in the upper tract in 93% (P = 0.05). Important complications encountered included chronic renal failure (13%),hydronephrosis (34%),systemic hypertension (8%),and rickets in 17%. Calcium oxalate was the most prominent constituent,seen in 41% of the calculi,followed by struvite (21%),uric acid (10%),carbapatite (7%),and cystine (3.5%). Diagnostically helpful findings were family history,age at presentation,UTI by urease producing organisms,rickets,imaging and chemical analysis of calculi. Early detection and prompt treatment helps in preventing long-term sequelae in patients with urolithiasis.