Analysis Of Composition And Influencing Factors Of Urinary Calculi In Children From Single Center In Hunan Province

Object: To discuss the characteristics of urinary calculi in children,and to analyze the influence of gender,age,region,stone location,urine metabolism and other factors on the composition of calculi.Methods: A total of 524 urinary calculus specimens were collected from children in Hunan who were admitted to the Department of Urology of Hunan Children’s Hospital from June 2015 to April 2019,combined with the clinical features of children with all and part of the analysis results of a day’s urine metabolism in children with stone composition and the relationship between the influencing factors is analyzed.All calculi were divided into single component calculi(n= 350)and mixed component calculi(n=174)according to their composition types.Among the single component calculi,they were classified as calcium oxalate calculi(n= 231),ammonium hydrogen urate calculi(n= 51),cystine calculi(n= 31),uric acid calculi(n= 16)and other calculi(n= 21)according to their composition types.According to different regional economic conditions,Hunan is divided into Changsha-Zhuzhou-Xiangtan region(n=116),The area around Changsha-Zhuzhou-Xiangtan(n=212),southern Hunan region(n=62),Dongting Lake region(n=85),and western Hunan region(n=49).Results: Among the 524 cases of urinary calculi in children in Hunan,365 cases were boys and 159 cases were girls,with a male-to-female ratio of 2.30:1.The average age was 5.61±3.88 years old,and the children at school age accounted for the most,accounting for29.20%(153/524),followed by the children at preschool and early school age,accounting for 27.48%(144/524)and 26.91%(141/524),respectively.Among all the calculi specimens,single component calculi were more than mixed component calculi(66.79% vs 33.21%),with a ratio of 2.01:1.Calcium oxalate and ammonium hydrogen urate were the main components of single component stone,accounting for 66.00%(231/350)and 14.57%(51/350),respectively.Calcium oxalate + apatite carbonate took the first place in the mixed stone composition,accounting for 37.93%(66/174).Among the single stone components,calcium oxalate(37.66%,87/231)and uric acid(43.75%,7/16)were more common at school age.Ammonium bisurate calculi were more common in early school age(37.25%,19/51);Uric acid calculi were all from children in the area around Changsha-Zhuzhou-Xiangtan,accounting for 11.34%(16/141)of the total cases of all single component calculi in this area.There were statistically significant differences in the distribution of stone sites in children with different genders and different single component calculi(P<0.05).Conclusion:1.The single component of urinary calculi in children in Hunan region is calcium oxalate,followed by ammonium hydrogen urate,and the mixed component is calcium oxalate + apatite carbonate.2.Among children with urinary calculi in Hunan,it is more common in males than females,and it is more common in early childhood,pre-school age and school age than in infancy and adolescence.3.There were differences in age,region and distribution of occurrence sites among children with different single component urinary calculi in Hunan.