International Journal of Urology (2000) 7, 330–334 Original Article Characteristics of pediatric urolithiasis in south-east Anatolia AYDIN ECE, 1 ENVER ÖZDEMIR, 2 FUAT GÜRKAN, 1 ALI IHSAN DOKUCU 3 AND OSMAN AKDENIZ 1 Dicle University Medical Faculty Departments of 1 Pediatrics, 2 Urology and 3 Pediatric Surgery, Diyarbakır, Turkey Abstract Background: Urolithiasis is endemic in Turkey and characteristics of urolithiasis vary in different regions of the world. The aim of the present study was to evaluate the etiological and clinical char- acteristics and course of pediatric urolithiasis in south-east Turkey. Methods: The study population consisted of 81 children (52 girls) with urolithiasis at a mean age of 6.2 ± 4.2 years who were followed up for 1–32 months. Results: Metabolic disorders, anatomical defects and infection stones were found to be the etiolo- gical factor in 34.6, 29.6 and 22.2% of patients, respectively, while 13.6% of patients were consid- ered idiopathic. Of all patients, 28.4% were admitted with acute renal failure (ARF) and 72.8% had urinary tract infection. Recurrence was seen in 19.8% of patients at presentation. The localiza- tion of the stone was found to be in the upper urinary tract, the lower urinary tract or both in 65.4, 14.8% and 17.3% of patients, respectively. Patients with multiple and bilateral stones had a higher risk for ARF than the others. The risk for chronic renal failure was significantly higher in children with multiple, bilateral or recurrent stones and with ARF at presentation. Conclusions: Early diagnosis and management of renal stones and urinary tract infections is necessary to prevent the development of ARF or chronic renal failure and to improve the quality of a patient’s life. Key words children, clinical characteristics, etiology, Turkey, urolithiasis. Introduction Urolithiasis is mainly a problem of adults and it has been estimated that the rate of occurrence during the entire lifetime is approximately 3–12%. 1 Pediatric urolithiasis is relatively uncommon and characteristics, including the incidence, localization and etiology, of pediatric urinary stone disease vary greatly according to geographic regions. Bladder stones have been reported to be endemic in south-east Asia and India, but upper urinary tract stones were found to be pre- dominant in Europe and North America. 2–4 Turkey is an endemic country for urinary stones, but knowledge about the characteristics of the disease is inadequate, particularly in the south-east region, a non-industrial- ized area with a hot climate. 5 In the present study, children with urolithiasis were investigated in order to present their general character- istics, including etiology, clinical course, complica- tions and treatment modalities, in this south-east region of Turkey. Methods The study population included 81 children followed up at Dicle University Hospital, a tertiary medical center admitting patients referred from all over south-east Turkey, with the diagnosis of urinary stone disease between 1996 and 1999. Data about patients’ clinical and laboratory characteristics were obtained from their Correspondence: Dr Aydın Ece, Dicle Üniversitesi Hastanesi, Çocuk Klinig ˇi, Diyarbakır, Turkey. Email: aydece@dicle.edu.tr Received 4 October 1999; revision 5 April 2000; ac- cepted 5 April 2000.