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Objective: To optimize the algorithm for early diagnosis of urolithiasis (UL) in children, considering risk factors, clinical and functional characteristics of the disease, and immunogenetic predisposition in an outpatient setting Methods: The literature on managing children with UL outside the hospital was thoroughly analyzed to achieve the goal. Medical records, risk factors, including immunogenetic predisposition, and clinical and laboratory investigation results of 652 hospitalized children with UL were studied. Additionally, a retrospective study of 379 outpatient records (the control group) and a prospective study of 1275 children (the study group) aged 1 to 18 was conducted. Based on the outpatient records analysis, the effectiveness of current and optimized management algorithms for children with UL was compared Results: As a result of the research, an algorithm for early diagnosis and prediction of UL in children, considering risk factors, including immunogenetic predisposition, was developed. The algorithm evaluates the risk of developing UL based on a thirteen-point checklist that assesses benefits and risks to provide a personalized risk score for each child. Based on this risk score, additional therapeutic interventions are determined for each patient Conclusion: The algorithm developed for early diagnosis and prediction of UL in children helps identify the condition at a preclinical stage in an outpatient setting. This algorithm categorizes patients into low-, moderate-, or high-risk groups and guides their management accordingly

Objective: To determine the genetic polymorphism associated with the development of urolithiasis (UL) in children of the Uzbek population. Methods: The study was conducted in the Specialized Children's Surgical Hospital of the Samarkand State Medical University between 2012 and 2019. In the first stage, a retrospective analysis of the case histories of 652 admitted patients was undertaken. In the second stage, 200 children aged 1 to 17 years were enrolled in the study, of which 100 were diagnosed with UL (main group), and 100 comprised the control group without UL (hospitalized for minor planned surgical interventions, such as circumcision or hernia repair). Immunogenetic studies of the vitamin D receptor (VDR), IL-1β, and IL-18 genes were carried out. Results: The obtained results indicate that polymorphism of the VDR and IL-1β genes plays an important role in susceptibility to UL. In the study groups, a statistically significant association of F/f+f/f genotypes of the VDR gene (Fok-1) with UL was found, which was 1.3 times more frequent in the main group than in the control one (p=0.033; χ2 =4.56). The C/C allele of the IL-1β gene was significantly more frequently detected in the main vs. control group (p=0.027; χ2 =7.23; df=2). The distribution of frequency of IL-18 (+105A/C) gene polymorphism for all models of inheritance was not statistically significantly different in the main and control groups (p>0.05; χ2 =3.93; df=2). Conclusion: : The role of the immunogenetic method in the detection of susceptibility to UL development was determined in the study of the distribution of polymorphic markers of the VDR and IL-1β genes, indicating the significance of the immunogenetic factors for the predisposition to UL in children of the Uzbek population which may predict the disease at its preclinical stage. Therefore, in the interests of the early diagnosis of UL in children of the Uzbek population, it is reasonable to include testing for FokI genotype and polymorphism of VDR and IL-1β genes in the complex program of examination.

According to the study literature, urolithiasis remains one of the most common nosologies among the child population. In connection with the global changes in the health status of the population of our planet, the social significance of urolithiasis has recently acquired new relevance. The mechanism of stone formation is a complex process; stones are formed as a result of urine saturation with oxalates, calcium, uric acid, cystine. Most stones in children are located in the upper urinary tract. In 15%-25% of cases in children, urolithiasis may be asymptomatic. Diagnostics today are not difficult. If urolithiasis is suspected, first, among the instrumental research methods, ultrasound examination of the urinary tract is used, which identifies both X-ray-positive and X-ray-negative stones. Nowadays, not all standards for treating obstructing stones of the upper urinary tract in children of various sizes and localizations, as well as the type of pelvis structure, have been defined. Simultaneously, new trends in treatment may change already existing standards. It should be noted that in the modern world, and ways of metaphylaxis urolithiasis in children studied insufficiently. In the world literature, there is insufficient information on predicting the occurrence of recurrence of urolithiasis and ways to eliminate them. This literature review examines the epidemiology, etiopathogenesis of urolithiasis, diagnosis, existing treatment standards and metaphylaxis. Methods of active tactics of treatment of obstructive stones of the upper urinary tract are analysed in more detail.

In recent years there can be observed a growing number of cases of urolithialis, both in children and in adults. Many pathogenic mechanisms of forming stones have been recognized and there is possible profounder diagnostics. Facing increasing problem of urolithialis in children, it is necessary to seek all possible causes of the disease to prevent forming stones, relapses and its further consequences. In most cases it is possible to diagnose metabolic abnormalities, of which the most frequent is hypercalciuria (excessive excretion of calcium in urine). In children, idiopathic hypercalciuria occurs the most frequently. It is possible to diagnose different types of hypercalciuria (absorptive, renal or resorptive) and apply appropriate treatment., A Case Report: We present two cases of patients with urolithialis and diagnosed renal hypercalciuria. Time of observation of the first patient was more than 6 years, of the second one - 9 years. In both cases there has been applied appropriate treatment, however it was the proper realization of the recommendations that influenced long-term results of the treatment. Even the most detailed examination cannot assure effectiveness if the patient and the parents do not have positive approach to the treatment.