Metabolic Abnormalities and Stone Composition in Pediatric Urolithiasis: A Retrospective Analysis

Background: Pediatric urolithiasis is increasingly prevalent and is often associated with underlying metabolic abnormalities. The objective is to evaluate the prevalence of metabolic abnormalities and their association with stone composition in pediatric patients. Material and Methods: This retrospective observational study included 50 pediatric patients (<18 years) diagnosed with urolithiasis between April 2024 and March 2026. Clinical data, metabolic evaluation, and stone composition analysis using infrared spectroscopy/X-ray diffraction were reviewed. Associations between metabolic abnormalities and stone types were analyzed using the chi-square test, with p<0.05 considered statistically significant. Results: The mean age was 12.4 ± 3.2 years, with male predominance (60%). Metabolic abnormalities were identified in 68% of patients. Hypercalciuria (36%) was the most common abnormality, followed by hyperoxaluria (22%) and hypocitraturia (18%). Calcium oxalate stones were most frequent (64%). A significant association was observed between hyperoxaluria and calcium oxalate stones (p=0.01). Recurrent stone disease was significantly associated with metabolic abnormalities (p=0.03). Conclusion: Metabolic abnormalities are highly prevalent in pediatric urolithiasis and significantly influence stone composition and recurrence. Routine metabolic evaluation is essential for targeted management and prevention.

Keywords: Pediatric urolithiasis; Hypercalciuria; Hyperoxaluria; Stone composition; Metabolic evaluation.