Prevalence of Metabolic Risk Factors Affecting Childhood Nephrolithiasis: A Report from a University Hospital in West of Iran

The prevalence of urolithiasis in both infants and children is increasing. The metabolic features contributing to urolithiasis formation in children may vary from those in adult patients. The purpose of this study is to determine the prevalence of urinary metabolic abnormalities and related factors in infants and children with urolithiasis in Kermanshah, West of Iran.

In this cross-sectional study, 104 children and infants with urolithiasis who were admitted to the Pediatrics Nephrology Clinic of Imam Reza Hospital in Kermanshah, Iran in 2018 were investigated. Urinary metabolic abnormalities, including hypercalciuria, hyperuricosuria, hyperoxaluria, and hypocitraturia and cystinuria, were examined using random urine samples.

Of the 104 children (66 boys and 38 girls) examined, 64 (61.5%) had at least one urinary metabolic abnormality. Hypercalciuria was the most common (31 patients, 29.8%), followed by hyperuricosuria (27 patients, 26%), hyperoxaluria (20 patients, 19.2%), hypocitraturia (13 patients, 12.5%), and cystinuria (one patient, 0.96%). Hyperuricosuria (88.9%) and hypocitraturia (46.2%) were more common in infants younger than 12 months old compared to those older. No statistically significant association was observed between the frequency of urinary metabolic abnormalities with gender and family history of urolithiasis, but a significant relationship was found between age and prevalence of urinary metabolic abnormalities.

Hypercalciuria was the most common metabolic abnormality in the urine. Although detection of urinary metabolic abnormalities is important, the role of other variables, like nutritional and climatic factors in the development of childhood nephrolithiasis should be considered too, since no metabolic disorder have been found in more than a third of patients.