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We evaluated the metabolic and the nutritional aspects of 134 urolithiasic children, in order to outline the risk factors that contribute to idiopathic stone formation in children.In this prospective study 134 children (56 females, 78 males) with renal calculi were evaluated. The age of the patients ranged 6 months to 16 years. A dietary survey was performed on every child. All patients were investigated with respect to stone localization, serum and urine risk factors. Statistical analysis of data was carried out using software SPSS 11.0 for Windows. Statistical significance was determined using chi-square test.Hypercalciuria was the commonest risk factor detected in this group (28.3%). A decrease of water intake was noted in all age group specially in the rural area (549.6 vs 1150.6 ml/day), and an increase in animal protein intake in 17 cases (mean 1.9 g/kg). In addition, increased intake of starchy foods and food with high oxalate content (sorgum) was observed in our 10-16 years group (51%). Calcium oxalate monohydrate represents the principal component of idiopathic stone (58.2%), which is more frequent in children (68%) than infants (51.7%) (P0.02).The high frequency of idiopathic urolithiasis highlights the influence of dietary habit in stone formers in our country. The increase in calcium oxalate stones in school-age children confirms the change in the etiology of urolithiasis according to age.

Studies evaluating the influence of age and gender on the distribution of the various types of paediatric urinary calculi are scarce. Aim of our study was to high-light the modification of epidemiological characteristics of this pathology depending on patients' age and gender.We present the results of a study based on 205 calculi (from 122 boys and 83 girls) analyzed by infrared spectroscopy between 1993 and 2007. 54.6% of the patients were under 5 years.Calcium oxalate (CaOx) was the predominant constituent in 54.7% of stones, followed by calcium phosphate and ammonium urate (14.6% each). We found a male preponderance for struvite stones (12.3% vs 1.2%), and an increasing prevalence of calcium oxalate stones with age (42.9% in infants vs 59.3% in older children). Purines stones were observed in 20% of cases, but their prevalence decreases with age (28.6% in infants vs 18.5% in old children).The increase of calcium oxalate stone rate in school age children and the decrease of purines stones confirm the change on the etiology of urolithiasis according to age.

To show an outline of the clinical and biological characteristics of paediatric urolithiasis among Tunisian children in the coast region.This retrospective study included 168 children under the age of 16 years presented with urinary stones (100 boys and 68 girls). Patients were reviewed in a multi-centric study with regard to age at diagnosis, sex, history, and physical, laboratory, and radiologic findings. The physical and chemical analysis of stones was carried out respectively by a stereomicroscope and by infra-red spectroscopy.The sex ratio was 1.47. The clinical presentation of this pathology was dominated by abdominal pain (28%), hematuria (25.6%), dysuria (16.7%) and urinary tract infection (14.3%). Stones were located in the upper urinary tract in 75.6% of cases. Of the urine cultures, 14.3% were positive. Whewellite was more frequent in children stones than in infants (p0.05) and was the main component in 46.4% of stone section and 55.4% in stone surface.The male prevalence of paediatric urolithiasis is progressively decreasing in Tunisia. The epidemiological profile of renal stones in our country has changed towards a predominance of calcium oxalate stone and upper tract location.

International studies may not reflect the real changes of stone disease in our own country. In this retrospective work, we describe the evolution of this pathology in Tunisia during the last 12 years.The records of 133 children with urolithiasis treated in Tunisia between 1994 and 2006 were reviewed. The physical and chemical analysis of stones was carried out respectively by a stereomicroscope and by infra-red spectroscopy and the epidemiologic data were collected.The male prevalence of this pathology is progressively declining. The male to female ratio, passed from 1.7 in the 1994-97 period to 1.5 in 2006. Upper urinary tract was most frequently affected by this pathology. Over the last 12 year period urinary tract infection was in continuous increase and currently reaches 50% being 21.9% in 1994. This explains the increasing frequency of struvite stones which passed from 15.6% in 1994 to 37.5% in 2006. Ammonium urate stones became more frequent in the last few years being the main component in 25% of cases (12.5% in 1994-97). Calcium oxalate monohydrate remains the most frequent stone component even if its frequency fell (59.4% in 1994 and 12.5% in 2006) in favour of the increase of phosphatic and phospho-calcic stones.The rise in the frequency of struvite and ammonium urate stone reflects an increase in the infectious risk factors in our country.