ESPU Congress 2018 - Abstract Book

179 11–14 APRIL, 2018, HELSINKI, FINLAND 11:58–12:01 S24-3 (PP) COMPOSITION OF STONES AND METABOLIC RISK FACTORS IN INFANTS. AN ENDEMIC COUNTRY EXPERIENCE Mirza Naqi ZAFAR Sindh Institute of Urology and Transplantation, Pathology, Karachi, PAKISTAN PURPOSE Pediatric urolithiasis remains endemic in low resource countries where infants constitute 17–40 % of all children with urolithiasis. This study reports socio-economic factors, medical history, chemical composition and metabolic risk factors in 1437 infants upto the age of 2 years from an endemic country. MATERIAL AND METHODS Between 1982–2016, 1437 infants presented to our institute with 1217 stones. Patients were evaluated for demographics, blood and 24 h urine for calcium, magnesium, phosphate, uric acid, electrolytes and additional protein, citrate, ammonia and oxalate in urine. Chemical composition of stones was analyzed by Fourier transformation infrared spectroscopy (FTIR). All reported values were two sided and statistical significance was considered at p value <=0.05. RESULTS The mean age of infants was 17.5±6.24 months with a M:F ratio of 5:1. Nearly half (50 %) of the infants were rural dwellers, 92 % belonged to low socio-economic class and 70 % were malnour- ished. A history of chronic diarrhoea was reported in 17 % and urinary tract infections in 8 %. Overall frequency of compounds in stones showed Ammonium acid urate (AAU) in 75 %, Calcium Oxalate (CaOx) in 40 %. Uric Acid (UA) in 12 %, Calcium phosphate apatite (CaP) in 7 %, Magnesium ammonium phosphate (Struvite) in 5 %), Cystine in 1 % and Xanthine in 5 %. Urinary metabolic abnormalities showed Hypocitraturia in 84 %, hyperoxaluria in 26 %, hyperuricosuria in 52 %, hy- perammonuria in 14 %, hyponatriuria in 49 % and hypovolemia in 50 %. CONCLUSIONS Our study has shown that AAU is a major component of stones in infants where the main risk factors are poverty, malnutrition, diarrheal diseases and dehydration.