Re: Silicate urolithiasis in a pediatric patient

First, the authors mentioned that there were no associated risk factors for silicate stone in any form in the studied child.[1] I presume that the following risk factor ought to be seriously considered. In India, ground water is being used as raw water for 85% public water supply.[2] It was found that all parameters of permissible limit of drinking water, including silicate were not set for all by different agencies, that is, the American Public Health Association, World Health Organization, Indian Standard Institution, Central Pollution Control Board, and Indian Council of Medical Research.[2] Importantly, a significant association was found between the silicate levels in drinking water and the high prevalence of various renal diseases, including stones among residents in certain localities in India.[3] I presume that precise estimate of silicate in the drinking water in the locality of the studied child is indicated and appropriate preventive measure would be needed to hamper the evolution of new cases.