Metabolic Evaluation in Pediatric Urolithiasis from Western Uttar Pradesh

Pediatric urolithiasis is an important medical problem, which has seen an increasing incidence in developing countries. A wide geographic variation in urolithiasis prevalence has been documented, which might be due to differences in diet, fluid intake, ethnicity and climate. The aim is to assess the biochemical and metabolic characteristics of the patients. The current study was conducted by the Department of Biochemistry of a tertiary care teaching hospital of western Uttar Pradesh. Pediatric patients presenting with urolithiasis formed the sampling frame. Medical records were studied for clinical and laboratory data. Study tools were records of the patients. Metabolic evaluation was done in all children. Sixty pediatric urolithiasis cases were included in this study. Gender wise, there were 23 females (38.3%) and 37 males (61.7%) with age ranged from 1 year to 11 years. Stone analysis revealed that big chunk (78.3%) of stones was renal stones. Vesicle calculus was least common (5%). On the other hand, Calcium oxalate stone was most common variety found in nearly half (46.20%) of the study participants. Least common variety (3.3%) was cystine type of stone. Hypocalcaemia was most common variety found in 86.67% of the study participants. Hyperuricaemia was observed in 3.33% of participants. Hyperoxaluria was the most common (78.3%) metabolic abnormality detected. 26.67% had Hypercalciuria. Only 5/29 (17.24%) patients managed conservatively had stone recurrence whereas 13/31 (41.9%) managed with a procedure had stone recurrence. Association of management modality with recurrence of Urinary Calculi was found statistically significant (p<0.05). Metabolic evaluation is advised in all pediatric patients as it helps in segregating patients needing medical therapy. Further studies are warranted to establish paediatric reference ranges for 24 hour urinary super saturation parameters in Indian population.