Renal stones in children in Pakistan.

One hundred and fifty children up to the age of 12 years with documented evidence of renal or ureteric stones were studied between July 1973 and June 1983. The peak age group was between 10 and 12 years, the male to female ratio being 1.9:1. Abdominal pain was the commonest presenting symptom (66.6%). Asymptomatic stones or vague symptoms in 23 patients warrant a higher index of suspicion of renal stone disease in children. Thirty patients had associated renal insufficiency. One third of the children had a positive urine culture, Proteus spp. being the commonest organism. Congenital anomalies of the urinary tract were seen in 12% of patients. In the majority (59%), aetiological factors related to stone formation could not be identified. One hundred and thirty patients underwent surgery for removal of stones. Analysis of calculi by X-ray diffraction and infrared spectroscopy revealed that stones were predominantly of mixed type, calcium oxalate being the commonest compound. The overall recurrence rate following surgical removal was 15%.