Stone composition and clinical characteristics of pediatric urolithiasis between Tibetan and non-Tibetan populations in Western China.

BACKGROUND

This study compared urinary stone composition and clinical characteristics between Tibetan and non-Tibetan children in Western China.

METHODS

This retrospective cross-sectional study included 237 children (aged 0-14 years) with urolithiasis hospitalized at West China Hospital (2008-2023). Stone composition was analyzed via Fourier-transform infrared spectroscopy. Independent associations were evaluated using multivariable logistic regression, alongside a sensitivity analysis restricting controls to Han Chinese (N = 198).

RESULTS

A total of 237 children were included (Tibetan, n = 121; non-Tibetan, n = 116). Calcium oxalate was the most frequently identified component in both groups (84.0%). Ammonium urate was significantly more prevalent among Tibetan children (35.5% vs. 14.7%, P < 0.001), with this disparity most pronounced among males (38.9% vs. 17.7%, P = 0.004) and toddlers (47.2% vs. 10.3%, P = 0.003). In multivariable logistic regression, Tibetan ethnicity was independently associated with the ammonium urate component across all models (adjusted OR 2.32, 95% CI 1.12-4.80, P = 0.023). The sensitivity analysis restricted to Han Chinese and Tibetan children (N = 198) yielded consistent and stronger effect estimates (adjusted OR 4.10, 95% CI 1.47-11.49, P = 0.007). Tibetan children also exhibited lower Prognostic Nutritional Index scores (P = 0.004) and serum uric acid levels (P = 0.002) across analyses.

CONCLUSION

Tibetan children exhibit a distinct urolithiasis profile with elevated prevalence of ammonium urate. This association, most pronounced in young children and males, may reflect nutritional and environmental factors linked to high-altitude residence, underscoring the need for ethnicity-informed prevention strategies.