Pediatric urolithiasis with renal failure: Siut experience |
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| Affiliation: | 4. Sindh institute of urology and transplantation, paediatric urology, karachi, pakistan;1. Sindh institute of urology and transplantation, pathology, karachi, pakistan;1. Department of Urology, Columbia University College of Physicians and Surgeons, New York, New York;2. Department of Urology, Icahn School of Medicine at Mount Sinai Hospital, New York, New York;3. Department of Urology, Medical College of Wisconsin, Milwaukee, Wisconsin;4. Surgical Service, Veterans Affairs Boston Healthcare System, Harvard Medical School, Boston, Massachusetts;1. Unit of Emerging Infectious Diseases, Institut Louis Malardé, Papeete, Tahiti, French Polynesia;2. Aix-Marseille Université, Institut de Recherche pour le Développement, Assistance Publique–Hôpitaux de Marseille, Service de Santé des Armées, Unité Mixte de Recherche Vecteurs–Infections Tropicales et Méditerranéennes (VITROME), Institut Hospitalo‐Universitaire–Méditerranée Infection, Marseille, France;3. Public Health and Infection Research Group, Faculty of Health Sciences, Universidad Tecnológica de Pereira, Pereira, Colombia;4. Colombian Collaborative Network of Research on Zika and other Arboviruses, Pereira, Colombia;5. Tropical Medicine Institute, University of São Paulo, and Hospital Israelita Albert Einstein, São Paulo, Brazil;6. Programme in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore;1. Division of Nephrology, Department of Pediatrics, College of Medicine, University of Florida, Gainesville, FL 32610, USA;2. Division of Pathology, Department of Pathology, Immunology and Laboratory Medicine, College of Medicine, University of Florida, Gainesville, FL 32610, USA;1. The Nephrology Center of the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China;2. Zhengzhou University Institute of Nephrology, Zhengzhou, China;1. Department of Paediatric Surgery and Urology, Chelsea and Westminster Hospital, London, UK;2. Department of Paediatric Surgery and Urology, John Radcliffe Hospital, Oxford, UK;3. Department of Paediatric Surgery and Urology, Leeds General Infirmary, Leeds, UK;4. Department of Paediatric Urology, Southampton University Hospital Trust, Southampton, UK;5. Department of Paediatric Urology, Birmingham Children''s Hospital, Birmingham, UK;6. Department of Paediatric Surgery and Urology, St George''s Hospital, London, UK |
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| Abstract: | ![]()
PurposePediatric urolithiasis is endemic in Pakistan and constitutes about 13% of all urolithiasis cases. Urolithiasis associated with renal failure is one of the most important cause of pediatric ESRD in Pakistan.Material and methodsRetrospective analysis of 402 children with urolithiasis and associated renal failure. Ultrasound was the mainstay of radiological diagnosis and assessment.Results402 patients, age ranged between 9 months to 14 years with male female ratio of 2:1. More than 50% had a positive family history of stone disease. Apart from obstruction and infection, poor socioeconomic status (89%), rural residence (66%), neglect and delay in acquiring treatment led to renal failure in these patients. The most common signs and symptoms were fever (56.7%), flank pain (55.2%), shortness of breath (38%) and vomiting (38.3%). 105 (26%) were anuric at presentation and 297 (74%) non-anuric. More than 60% of these patients had bilateral stones and associated urinary tract infection. The initial management of these patients required dialysis mostly peritoneal dialysis in small children. Percutaneous nephrostomy with or with out dialysis was also the main stay of initial management especiallyfor those presenting with a pyonephrosis. In some “Double J” stents were also placed to relieve obstruction. Details of operative procedures for definitive treatment and type of stones will be provided in presentation.ConclusionsAbout 70% of the patients had good recovery of renal function. These good results were achieved because of the provision of free high technological treatment to all our patients under one roof with close co-operation of pediatric urology, nephrology and intensive care teams. |
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