An Update on the Changing Epidemiology and Metabolic Risk Factors in Pediatric Kidney Stone Disease

Abstract

SummaryNephrolithiasis in children is a painful and costly disease that may also have detrimental long-term effects on kidney function. Recent data provide evidence that the incidence of nephrolithiasis in children is rising. Children who are white, female, and adolescent seem to have the highest risk for forming symptomatic kidney stones. Although the reasons for the rising incidence and demographic discrepancies in pediatric nephrolithiasis are not yet clear, recent investigations into urine chemistry provide clues regarding predisposing metabolic risk factors. As more data emerge regarding epidemiologic and metabolic characteristics of pediatric kidney stone formers, we hope to gain a better understanding of the causes of kidney stone disease and, ultimately, provide better strategies for stone prevention in children.

Pediatric Nephrolithiasis: Trend, Evaluation and Management: A Systematic Review

“…On the other hand, in recent studies, low fluid consumption, particularly water, has been considered as an etiological factor in kidney stone (20,30,31). In fact, super saturation of ions in urine such as calcium and oxalate directly depend on the volume of urine, hence an appropriate hydration could protect the stone formation.…”

“…Struvite stones also in the setting of spinal cord injuries or neurogenic bladders might be considered. In patients with seizures, ketogenic diet and anti-seizer medications result in acidosis, hypercalciuria that need more attention (27-29).On the other hand, in recent studies, low fluid consumption, particularly water, has been considered as an etiological factor in kidney stone (20,30,31). In fact, super saturation of ions in urine such as calcium and oxalate directly depend on the volume of urine, hence an appropriate hydration could protect the stone formation.…”

“…Among them, hypercalciuria, hyperuricosuria and cystinuria make 34 to 50%, 20% and 20% of metabolic abnormalities, respectively in pediatric nephrolithiasis (36-38). In the recurrence of nephrolithiasis, we need to evaluate the patients for inherited disorder such as PH, cystinuria, Dent disease and familial hypomagnesemia (20,39 (44), in a populationbased study on 2871 patients aged 2 months to 18 years revealed that 420 (14.6%) were overweight and 440 (15.3%) were obese. They concluded that increased BMI in children was associated with increased overall complications.…”

Pediatric idiopathic hypercalciuria with bilateral nephrolithiasis and hypertensive urgency

“…In the United States, pediatric nephrolithiasis accounts for 1 per 1,000 to 7,600 pediatric hospital admissions. (1)(2)(3) Data from Indonesia are not available. Approximately 50% of these patients have an onset around 5 years of age.…”

“…Most causes of hypercalciuria are idiopathic, both sporadic and familial. (2) Hypercalciuria with nephrolithiasis is associated with a wide variety of symptoms. The most common symptoms are abdominal pain (53-75%), gross hematuria (14-33%), and dysuria (15%), although 15% of cases present as an asymptomatic, incidental radiologic finding.…”