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.