Kiran Imran, Mirza Naqi Zafar, Naureen Fatima, Uzma Ozair, Sajid Sultan, Syed Adibul Hasan Rizvi


Background: Chemical composition of stones is one of the important diagnostic criteria for aetiology of stone formation and treatment to prevent recurrence. This paper reports composition of stones in children at a tertiary hospital by Fourier Transformation Infrared Spectroscopy (FTIR). Methods: Between January–June 2015, 412 urinary stones from children were analysed by FTIR. Chi-square tests were used for the comparison of categorical measurements between groups. All reported values were 2-sided and statistical significance was considered at p-value ≤0.05. Results: Of the 412 stones, 263 (63.8%) were renal, 101(24.5%) bladder and 48 (11.7%) ureteric. The mean age of children was 7.15±4.13 years with a M:F ratio 2.4:1. Of the 412 stones, 144(34.9%) were pure stones composed of one compound and 268(65.1%) were mixtures. Frequency of compound in stones was Ammonium Acid Urate (AAU) (65%), Calcium Oxalate (CaOx) (76.9%), Uric Acid (5%), Calcium Phosphate Apatite (7%), Whitlockite (8.4%), Struvite (4%), Cystine (0.72%) and Xanthine (2.11%). Frequency of compounds analysed in three ages groups 0-5, 6–10 and 11–15 years showed high frequency of AAU (73%) in 0-5 years as compared to (60%) in 11–15 years (p<0.018). CaOx (90%) in 11–15 as compared to (62.5%) in 0-5 years (p<0.001). Bladder stones were more prevalent in children 0-5 years (32%) vs 19% in 11–15 years (p<0.004) while renal were 75% in 11–15 years and 54% in 0-5 years (p<0.04). Conclusion: AAU stones known to be associated with malnutrition and chronic diarrhoea are highly prevalent in paediatric stones formers in our population in the kidney, bladder and ureter.

Keywords: Paediatric; urolithiasis; chemical composition

Full Text:



Shah AM, Kalmunkar S, Punekar SV, Billimoria FR, Bapat SD, Deshmukh SS. Spectrum of pediatric urolithiasis in western India. Indian J Pediatr 1991;58(4):543–9.

Rizvi SA, Naqvi SA, Hussain Z, Hashmi A, Hussain M, Zafar MN, et al. Pediatric urolithiasis: developing nation perspectives. J Urol 2002;168(4 Pt 1):1522–5.

Yoshida O, Okada Y. Epidemiology of urolithiasis in Japan: a chronological and geographical study. Urol Int 1990;45(2):104–11.

Elsobky E, Sheir KZ, Madbouly K, Mokhtar AA. Extracorporeal shock wave lithotripsy in children: experience using two second-generation lithotripters. BJU Int 2000;86(7):851–6.

Türk C, Knoll T, Petrik A, Sarica K, Straub M, Seitz C, et al. Guidelines on urolithiasis 2014. European Association of Urology; 2014.

Pearle MS, Goldfarb DS, Assimos DG, Curhan G, Denu-Ciocca CJ, Matlaga BR, et al. Medical management of kidney stones: AUA guideline. J Urol 2014;192(2):316–24.

Hess A, Sanders G. Atlas of infrared spectra for the analysis of urinary concrements. Stuttgart-New York; 1988.

López M, Hoppe B. History, epidemiology and regional diversities of urolithiasis. Pediatr Nephrol 2010;25(1):49–59.

Clayton DB, Pope JC. The increasing pediatric stone disease problem. Ther Adv Urol 2011;3(1):3–12.

Aggour A, Ziada AM, AbdelHamid AZ, AbdelRahman S, Morsi A. Metabolic stone composition in Egyptian children. J Pediatr Urol 2009;5(2):132–5.

Alaya A, Belgith M, Hammadi S, Nouri A, Najjar MF. Kidney stones in children and teenagers in the central coast region of Tunisia. Iran J Pediatr 2012;22(3):290–6.

Alaya A, Najjar MF, Nouri A. Changes in stone composition according to age in Tunisian pediatric patients. Int Urol Nephrol 2010;42(3):621–8.

Ahmed I, Akhtar T, Ahmad B. Pediatric nephrolithiasis in Khyber Pakhtunkhwa province, Pakistan. Pak J Med Sci 2012;28(5):835–8.

Gabrielsen JS, Laciak RJ, Frank EL, McFadden M, Bates CS, Oottamasathien S, et al. Pediatric urinary stone composition in the United States. J Urol 2012;187(6):2182–7.

Kit LC, Filler G, Pike J, Leonard MP. Pediatric urolithiasis: experience at a tertiary care pediatric hospital. Can Urol Assoc J 2008;2(4):381–6.

Kirejczyk JK, Porowski T, Filonowicz R, Kazberuk A, Stefanowicz M, Wasilewska A, et al. An association between kidney stone composition and urinary metabolic disturbances in children. J Pediatr Urol 2014;10(1):130–5.

Wu W, Yang B, Ou L, Liang Y, Wan S, Li S, et al. Urinary stone analysis on 12,846 patients: a report from a single center in China. Urolithiasis 2014;42(1):39–43.

United Nations Development Programme, Malik K. Human Development Report 2014: Sustaining Human Progress-Reducing Vulnerabilities and Building Resilience (PDF). UN; 2014.

Rizvi SA, Sultan S, Zafar MN, Ahmed B, Faiq SM, Hossain KZ, et al. Evaluation of children with urolithiasis. Indian J Urol 2007;23(4):420–7.

Milliner DS, Murphy ME. Urolithiasis in pediatric patients. Mayo Clin Proc 1993;68(3):241–8.

Lee ST, Cho H. Metabolic features and renal outcomes of urolithiasis in children. Ren Fail 2016;38(6):927–32.

Celiksoy MH, Yilmaz A, Aydogan G, Kiyak A, Topal E, Sander S. Metabolic disorders in Turkish children with urolithiasis. Urology 2015;85(4):909–13.

Tamošaitytė S, Hendrixson V, Želvys A, Tyla R, Kučinskienė ZA, Jankevičius F, et al. Combined studies of chemical composition of urine sediments and kidney stones by means of infrared microspectroscopy. J Biomed Opt 2013;18(2):27011.

Primiano A, Persichilli S, Gambaro G, Ferraro PM, D'Addessi A, Cocci A, et al. FT-IR analysis of urinary stones: a helpful tool for clinician comparison with the chemical spot test. Dis Markers 2014;2014:176165.


  • There are currently no refbacks.

Contact Number: +92-992-382571

email: [jamc] [@] []