THE RELATIONSHIP BETWEEN SPECIFIC RISK FACTORS AND UROLITHIASIS IN CHILDREN

Objective: This study aimed to compare clinical, anamnestic, anthropometric, and laboratory parameters in children with urolithiasis according to the presence of a dominant inheritance (unfavorable genotype). Additionally, the study evaluated the prognostic value of vitamin D levels regarding disease recurrence. Methods: A total of 100 children, aged 8 months to 18 years (mean age 13.4±0.8 years), treated at the Multidisciplinary Specialized Center for Pediatric Surgery (2nd Clinic) of Samarkand State Medical University, Samarkand, Uzbekistan, were included. Patients were divided into two subgroups based on hereditary predisposition: subgroup 1 (n=80), children with dominant inheritance of urolithiasis (unfavorable genotype); and subgroup 2 (n=20), children without dominant inheritance. Data were collected using anamnestic, clinical, anthropometric, laboratory, imaging, and immunogenetic research methods. Results: School-aged children predominated the cohort, with 43% aged 4-11 years and 46% aged 12-18 years; the male-to-female ratio was approximately 2:1 (67% boys, 33% girls). In the dominant inheritance subgroup, abdominal pain (75%), lumbar pain (69%), macrohematuria (65%), and dysuria (57%) were more prevalent. However, the only statistically significant intergroup difference was the frequency of dry skin (51% vs. 25%; p=0.045). Anthropometric analysis revealed a trend toward lower body weight, height, and BMI relative to age-matched medians. Vitamin D deficiency was significantly more common in children with recurrent urolithiasis than in those with primary urolithiasis (35.0% vs. 16.3%; p<0.05). A 25(OH)D level <25 ng/ml was strongly associated with an increased risk of relapse (RR=13.5; Sensitivity=88.2%; Specificity=80.3%). Conclusion: The clinical course and recurrence risk in pediatric urolithiasis should be assessed by integrating hereditary predisposition, clinical symptoms, anthropometric status, and vitamin D levels. A serum 25(OH)D concentration below 25 ng/mL is a significant prognostic marker for recurrence, warranting regular laboratory monitoring. Keywords: Urolithiasis, risk factors, recurrence, hereditary predisposition, clinical symptoms, anthropometric status, vitamin D, pediatrics.

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