Abstract
Abstract Objective: To study the clinical efficiency of the urine Urease Activity (UA) test to diagnose kidney stones formation in children with urolithiasis. The prospective observational study was conducted at the Scientific Centre of Pediatrics and Pediatric Surgery (Almaty, Kazakhstan). This study included 80 patients: 40 patients with urolithiasis and 40 conditionally healthy children. The urine UA, standard urinalysis, and special methods of urine examination have been carried out for all patients. The clinical efficiency of the urine UA test was determined after comparison it with other lab tests and severity of urolithiasis among the different subgroups. The urine UA was correlated with the standard urinalysis. Patients with the high UA, between 110 and 400 mmol/l, also had the high numbers of WBC 187 [32-292], RBC 17 [3-34], and bacteria >105. These patients had most severe symptoms of urolithiasis including an inflammation. At the same time, low UA (0-50 mmol/l) were recorded for the patients with the mild symptoms. High level of UA was observed only in urine samples with phosphate and ammonium biurate crystals. The main bacterial pathogens in these cases were Klebsiella pneumonia and Pseudomonas aeruginosa. The values of UA were determined for the different types of crystals and uropathogens as well. Conclusion: The urine UA is the clinically efficient test for the diagnosis of kidney stone formation and reflects the presence of active urease-forming bacteria in urine, that contributes to the formation of the infected stones.