A retrospective review was performed of the records of 148 Croatian children with
urolithiasis treated between 1989 and 2003. The study evaluated age, gender, family
history, clinical symptoms, location of stone, laboratory findings, stone composition,
mode of treatment and compared our results with data from higher and lower socio-economic
countries. The mean age of our patients was 9.38 years (10 months to 18 years).
Thirty-seven children (25%) were less than 5 years (group 1), 44 (29.7%) were between 5
and 10 years (group 2) and 67 (45.3%) were older than 10 years of age (group 3). There
were 60 girls and 88 boys with overall male to female ratio of 1.47. Abdominal pain
(83%) and haematuria (59.5%) were the main symptoms in the groups 2 and 3. Urinary
tract infection was predominant symptom in the group 1 (62.1%). Calculi were located
in the kidney in 90 children (60.8%), in the ureter in 39 (26.4%), in the bladder in 8
(5.4%). Urinary tract anomalies with or without infection were associate with a greater
frequency of urolithiasis in the youngest age group and hypercalciuria was predominant
cause in children over 5. Stone analysis was performed in 80 children. Predominant
constituent of stones was calcium oxalate (48.7%), followed by struvite (25%), calcium
phosphate (13.7%), cystine (10%) and uric acid (1.2%). Calcium oxalate stones were
most common in all age groups. Struvite stones were most prevalent in the children
younger than 5 years of age. Most patients (33.1%) underwent surgery for removal of
their calculi. In 31.8% of children stones were passed spontaneously and the highest
spontaneous passage rate was in the group 3 (37.3%). Stone composition, location and
etiology in Croatian children are similar to those in developed Western countries
