Urinary stone disease in pediatric patients: a mixed-methods study

Year 2024, Volume: 7 Issue: 6, 681 - 690, 27.10.2024

Hülya Gözde Önal , Yonca Semet

Abstract

Aims: Childhood urinary stone disease (USSD) varies in frequency based on several factors such as, gender, age, body mass index, geography, diet, genetic disorders, and kidney anatomy. This study aims to retrospectively evaluate the demographic and clinical characteristics, symptoms, diagnostic methods, predisposing factors, associated urinary system anomalies, treatments, and prognosis of patients diagnosed with USSD in our clinic over the past three years.
Methods: This mixed-methods study retrospectively examined the records of 175 patients diagnosed with USSD between April 2020 and May 2023. Demographic data, symptoms, laboratory results, imaging findings, and treatment outcomes were analyzed. Additionally, qualitative data were gathered from semi-structured interviews with 10 volunteer participants to understand the impact of symptoms on their lives.
Results: Among the 175 pediatric patients diagnosed with urolithiasis, 120 (68.5%) were symptomatic, with common complaints such as irritability (29.1%), pain (18.2%), vomiting (23.4%), and macroscopic hematuria (20%). Significant differences were observed in symptoms based on age and stone size, with older children more likely to experience pain and hematuria, while younger children showed more irritability (p<0.01). Metabolic disorders were present in 78.8% of cases, with hypercalciuria being the most frequent. Qualitative data revealed significant emotional and social challenges. Children expressed fear, anxiety, and embarrassment due to symptoms like pain and bedwetting. These experiences impacted their daily lives, disrupting sleep, play, and social interactions. Family support played a crucial role in managing these emotional burdens, though peer interactions often exacerbated feelings of isolation and discomfort.
Conclusion: The study highlights the critical importance of early diagnosis and individualized treatment strategies in managing pediatric urolithiasis to prevent long-term complications like end-stage renal failure. Presenting symptoms and treatment outcomes are significantly influenced by factors such as age, stone size, and metabolic risk factors. Medical treatment remains the primary approach, while surgical interventions are reserved for complex cases. The findings emphasize the need for personalized management plans, particularly for high-risk children with family history or consanguineous marriages, and underscore the emotional and social challenges these children face.

Keywords

Childhood urinary stone disease, USSD, demographics and clinical characteristics, symptoms, metabolic risk factors

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