Introduction & Background: UROLITHIASIS in children is not a common disease in western countries. UROLITHIASIS in children is more located in the upper urinary tract and only 5-10% is seen in the bladder. The most com-moon stone composition differs in variable age groups but calcium oxalate seems to be the most common type in all children age groups. Clinical manifestations also differ in different age groups. In infants, growth retardation (FTT) and crying during crystaluria are the most common symptoms and signs. High resolution (HR) zoography (7.5 MHz) is an effective, noninvasive, and easy to access procedure for the diagnosis of infantile UROLITHIASIS. Even with high resolution zoography (7.5 MHz) we can determine the grading of nephrocalcino-sis in infants. Non radio-opaque stones are also diagnosed by HR zoography. Patients & Methods: This study tries to emphasize the importance and efficacy of high resolution sonography in the diagnosis of infantile UROLITHIASIS by surveillance of 200 infants under 2 years old with urinary tract stones in Markaz-Tebi-Hospital during 1375 to 1383. Results: In this study the mean age was 12 months old (2 to 24 months) and 55% were boys; 61% had positive family history; 54.5% (109 ones) had no underlying metabolic disorder and among others 41 (20.5%) had hy-percalciuria ( the most common ); 78 (39%) had hematuria, 61 (30.5%) had pyuria and 61 (30.5%) had no ab-normality in U/A. In 63 (31.5%), urine culture was positive; 39 (31.5%) had macroscopic hematuria. Their chief complaint was changing of urine color in 44 (22%), crystaluria in 37 (18.5%), UTI in 37 (31%), and no complaints in 20 (10%). FTT and crying during urination were observed in 25 (12.5%) and 12 (6%) of our pa-tients. In 79.5% of all infants, there was a positive sonographic finding that confirmed the stone. About the stone location according to the sonographic finding, 124 (62%) had kidney stone, 10 (4.5%) had ureter stone, and 25 (12.5%) had bladder stone. In 31 patients (6.5%), stone composition was urate, in 48 (24%) it was cal-cium oxalate, in 5 (2.5%) it was cystine, and in 14 (7%) it was struvite. Among 63 infants with positive urine culture, 49 patients (30.8%) and among 137 infants with negative urine culture, 110 (69.2%) had positive sonographic findings. Among 39 infants with macroscopic hematuria, 35 (22%), and among 161 without mac-roscopic hematuria, 124 (78%) had positive sonographic findings. Among 124 infants with kidney stones, all of them (78%), among 34 patients with ureter stone only 10 (6.3%) and among 25 infants with bladder stone, all of them (15.7%) had positive sonographic findings. Among 13 infants with urate stone, 11 (6.9%), among 48 patients with oxalate stone, 39 (24.5%), among 5 infants with cystine stones, 4 (2.5%), among 14 with struvite stones, 12 (7.5%), and among 120 infants with undetermined stone composition, 93 (58.5%) had positive sonographic findings. Conclusion: According to the results of this study and based on the importance of diagnosis of infantile uro-lithiasis, it seems necessary or useful to do HR sonography (7.5 MHz) especially in infants with specific or non-specific symptoms of UROLITHIASIS, infants with FTT with no good reason infants with recurrent UTI, infants with infantile errors of metabolism especially cystinuria, infants with proven UROLITHIASIS during courses of treatment. 

Introduction: UROLITHIASIS is increasingly recognized in pediatric patients and is encountered in a variety of clinical settings. Understandings of how and why stones form, along with knowledge of the pathophysiologic states that promote urinary tract calculi, provide the basis for effective clinical management. The aim of this study was to evaluate the clinical features, metabolic and anatomic risk factors in children with UROLITHIASIS.Methods: Between 2004 and 2009, 84 children (35 girls, 49 boys) followed in our department because of UROLITHIASIS were enrolled to participate in our study. Clinical presentation, urinary tract infection, stone localization, positive family history, stone composition, presence of anatomic abnormalities and urinary metabolic risk factors were evaluated retrospectively. Evaluation included serumbiochemistry; measurement of daily excretion of urinary calcium, uric acid, oxalate, citrate, and magnesium (in older children); and measurement of calcium, uric acid, oxalate, and creatinine in random urine samples in nontoilet-trained patients.Results: We investigated 84 patients (35 females and 49 males) with UROLITHIASIS between 6 months and 16 years of age (mean age 5.25 ± 3.61 years). The stones’ diameter was 3.2 to 31 mm (mean7.31 ± 4.64). In 90.6% of cases the stone was located only in kidneys and in 2.4% only in bladder. The most common causes of presentation were urinary tract infection (UTI), restlessness and abdominal pain. Positive family history was detected in 27.3%, UTI in 23.8%, anatomic abnormality in 10.7% of patients. Metabolic evaluation, which was carried out in 78 patients, revealed that 104 (52.6%) of them had a metabolic riskfactor including normocalcemichypercalciuria (21.7%), Hyperuricosuria (11.5%), Cystinuria (3.8%), and Hyperoxaluria (5.1%). Anatomical malformation was found in 12 children (14.3%) including vesicoureteral reflux in 3, ureteropelvic junction stenosis in 5 and bilateral duplex system in 2, horseshoe kidney and ureterovesical junction obstruction one each.Conclusions: We think that UROLITHIASIS remains a serious problem in children in our country. Family history of UROLITHIASIS, urologic abnormalities (especially under the age of 5 years), metabolic disorders and urinary tract infections tend to indicate childhood UROLITHIASIS. It is plausible to consider that better understanding of the causes of pediatric-age UROLITHIASIS may lead to earlier diagnosis and appropriate treatment of the metabolic diseases and hence the prevention of renal damage and recurrences may be possible.

Background and Aim: Urinary stones are a common problem among children that causes pain, dysuria, and other complications, including urinary tract obstruction and infection. The prevalence of urinary stones in children has been increasing in recent decades. Since the causes of UROLITHIASIS in children differ in various geographical regions, with diverse ethnic backgrounds and popular nutritional habits changing over time, we designed this study to update the identifiable etiologies of urinary stones in children younger than 14 years in Northwest Iran. Methods: This cross-sectional study was conducted on 144 children with urinary stones who were referred to Tabriz Children’, s Hospital, Tabriz City, Iran, from March 2018 to September 2020. To determine the main causes of UROLITHIASIS, such as metabolic disorders, urinary tract infections, and anatomical abnormalities, several variables, including age, sex, and results of ultrasound examination, urine analysis and biochemical tests, urine culture, and blood gas analysis, were collected, analyzed, and interpreted. Results: In this study, 90 boys and 54 girls with an average age of 11. 75 (ranged: 1-160) months were included. The most common causes of UROLITHIASIS were metabolic or biochemical disorders in 67 cases (46. 5%), mainly hypercalciuria followed by hyperoxaluria, anatomical abnormalities in 10 children (7%), and urinary tract infections in 3 patients (2. 1%). Dehydration leading to excessive urine concentration in 87 children (60. 4%) was the most common condition associated with UROLITHIASIS in the studied children. Conclusion: Regarding the high prevalence of metabolic disorders, especially hypercalciuria in children with UROLITHIASIS, these disorders should be considered for preventive, diagnostic, and therapeutic measures.