Nutritional Status, Socio-economic and Clinical Characteristics of Children with Renal Stone Diseases in Soba University Hospital - Khartoum State

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Omema Saper Gesmallah, Fadlallah
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The objectives of this study were to describe the general socioeconomical characteristics and nutritional status of children suffering from renal stone diseases at Soba University Hospital, and to investigate some dietary habits associated with the risk of this disease. The study consisted of 106 children with renal stone diseases and 50 controls. The samples were selected from patients admitted to the Paediatric Surgery and Pediatrics Medicine departments at Soba University Hospital, Khartoum State, during the period from June 2008- June 2009. Data collection included questionnaires focused on some socioeconomical characteristics, medical history and dietary intake (24 hour recalls and food frequency questionnaires), anthropometric measurements (weight, height and BMI), laboratory assessments (urine analysis, serum blood sample and stone analysis), and clinical data (recurrence of stone, symptoms, location of stone and complications). Patient's age ranged from 5 months to 18 years with mean age of patients 5.9 ± 4.40 years. Sex distribution was 74.5% males and 25.5% females Males were found to be more prone to urinary stones compared to females; the ratio was 2.9:1 and more common among the age group 2 to 10 years (53%). The results showed that most patients were from Western Sudan (44.8%) and generally most of them belong to significantly lower socioeconomic strata compared to the controls. E.g. Up to 12.3% of the patients’ fathers and 17.9% of their mothers were found to be illiterate compared to 6% and 8% respectively among the controls. More than half (52%) of the patients live in either slums or houses made of mud compared to only 32% of the controls. Only 10% of patients have an advanced toilet drainage systems compared to 44.9% of the controls. Electrical and water pipe supply was found in 63.2% and 69.8% of the patients homes respectively compared to 76% and 83% respectively in the homes of the controls. Concerning the nutritional status of this population, up to 57.5% of patients was found to be under weight compared 38% of the controls. Regarding food intake, milk consumption was significantly lower among patients compared to controls. Intake of meat, peanuts, broad beans and chocolates were significantly higher among patients compared to controls. No significant difference between patients and controls regarding their consumption of potato chips, tomato, okra, and tea. Energy intake of patients was found to be lower than the recommended in 41.2% (less than 80% of the recommended). However, the protein intake was found to be very high in 91.2%, and in 66% of the patients phosphorus intake was high (more than 110% of the recommended). The study also found that the most common symptoms associated with renal stone disease among these children were abdominal pain, urinary tract infection, haematuria and obstruction. 65.1% of the stones were located in the pelvis of the kidney and renal failure due to stone was found in 25.5%. Family history was seen in 40.6% of the patients, and recurrence of the disease was found among 28.3%. Serum creatinine, calcium, and uric acid were normal in most patients and in 69.2% the serum phosphate was high. Stone analysis showed that uric acid was the commonest constituent (64%), followed by calcium oxalate (49.3%), and Cystine was found in 9%. Kidney stone diseases among the studied population were very common. This study provides support for the belief that a diet high in protein and a diet low in calcium increase the risk of stones. Many foods were suggested as possible important determinants of renal stone formation. Therefore, more in-depth studies are needed to investigate the role of certain foods which showed strong association with the risk of renal stone formation among children.
Nutritional Status, Socio-economic, Clinical Characteristics of Children