Objective: Urinary system stone disease has become more common in children due to the widespread use of diagnostic methods, an increase in sedentary lifestyles and changes in nutrition habits. Compared to adults, children are exposed to stonerelated morbidity due to the presence of metabolic risk factors. In this study, it was aimed to evaluate the metabolic etiologies of children with urolithiasis and their medical care response.

Material and Method: Metabolic risk factors and treatment responses were evaluated for children who were treated for urinary system stone disease and regularly monitored bimonthly. Stone disease was detected by ultrasonography and / or computed tomography. Calcium, uric acid, oxalate, citrate, cystine and phosphate measurements were performed in 24-hour urine in all cases.

Results: The median age at diagnosis of urolithiasis in 196 children was 3.9 years (range: 3 months-16 years), and follow-up duration was 4.2 years (range: 3 months-8 years). The most common presenting symptoms were flank or abdominal pain (30.6%). Hyperuricosuria (n:59, %23.8), hypocitraturia (n:55, %22.2) and hypercalciuria (n:51, %20.6) was the most common metabolic abnormality. The patients who had metabolic risk factors were treated according to underlying metabolic abnormalities. At the last control visit, while about half of the patients (%52) were stone free, the stones were diminished in size in 28 patients (%14.3); there was no change in the size of the stone in 51 patients (26%), whereas stone size increased in 15 patients (7.7%).

Conclusion: By planning appropriate treatment for the metabolic abnormalities determined in children with urolithiasis, success can be achieved in many patients by medical treatments without the need of surgical methods.