Alaya Akram, Nouri Abdellatif, Najjar Mohamed Fadhel
Department of Biochemistry and Toxicology, University Hospital, Monastir, Tunisia.
Saudi J Kidney Dis Transpl. 2009 Nov;20(6):1096-100.
The aim of this study is to assess the clinical and biological characteristics of renal stone disease among children living in the coastal region of Tunisia. This retrospective multi-center study included 100 children under the age of 16 years, who presented with urinary stones. The patients' charts were reviewed with regard to age at diagnosis, sex, history and physical examination as well as laboratory and radiologic findings. Stone analysis was performed by infrared spectrophotometry. The male/female sex ratio was 1.5 to 1. The clinical presentation of this pathology was dominated by dysuria. Stones were located in the upper urinary tract in 76 cases (76%). A total of 13% of the study subjects had positive urine cultures. Metabolic investigations were performed in all patients and were normal in 80 cases. Whewellite (calcium oxalate) was found in 77 stones (77.0%). Stone section was made of whewellite in 69.0% of cases and ammonium urate in 47.0%. Struvite stones were more frequently seen in the lower urinary tract. Our study suggests that the epidemiological profile of renal stones in Tunisia has changed towards a predominance of calcium oxalate stones and upper tract location. Also, the male predominance of pediatric urolithiasis is becoming less obvious in Tunisia.
本研究的目的是评估突尼斯沿海地区儿童肾结石病的临床和生物学特征。这项回顾性多中心研究纳入了100名16岁以下患有尿路结石的儿童。对患者病历进行了回顾，内容包括诊断时的年龄、性别、病史、体格检查以及实验室和影像学检查结果。通过红外分光光度法进行结石分析。男女比例为1.5比1。该疾病的临床表现以排尿困难为主。76例（76%）结石位于上尿路。共有13%的研究对象尿培养呈阳性。对所有患者进行了代谢检查，80例结果正常。77块结石（77.0%）中发现了水草酸钙（草酸钙）。69.0%的病例结石断面由水草酸钙构成，47.0%由尿酸铵构成。磷酸铵镁结石在下尿路更为常见。我们的研究表明，突尼斯肾结石的流行病学特征已朝着以草酸钙结石和上尿路结石为主的方向转变。此外，突尼斯小儿尿路结石的男性优势正变得不那么明显。
