University of Alabama Marnix E. Heersink School of Medicine
Introduction: Nephrolithiasis has become increasingly prevalent in both the adult and pediatric populations over the last several decades. Some studies indicate a rapid rise in adolescents, particularly African American women. This study seeks the trends in symptomatic kidney stone occurrences in the pediatric population in Southeast United States to aid in identifying at-risk individuals.
Methods: After IRB approval, review of the data (ICD10 N20.0, N20.1, N13.2; ICD9 5920, 5921) yielded 644 pediatric occurrences of nephrolithiasis at single site emergency department (ED) from 2006 to 2020. Percent change and average percent change in three-year intervals were calculated to establish trend over time. A chi-square of independence was performed to assess association between race, gender, and age groups and binary logistic regression model was utilized to confirm associations.
Results: A total of 780 stone occurrences and associated patient demographic data was reviewed for 644 children (364, 56.52% female) with median age of 183 ± 45.11 months (9-397 months). Of the 644 children, 79 (12.3%) patients were noted to have recurrent symptomatic nephrolithiasis, contributing 136/780 stone events cases.
There was a marked increase of 84.4% in confirmed pediatric nephrolithiasis occurrences over 15 years, with an average percent increase of 16.1% every three years. A chi-square test of independence was performed to examine the relation between gender and race; the relation between these variables was significant, X 2(1, N=66) = 5.29, p=0.021.
On multivariate analysis, white females are at increased risk for stone disease (OR: 1.68; 95% CI 1.087, 2.59; p=0.019) in the pediatric population. Our data did reflect that a greater percentage of symptomatic nephrolithiasis presentations occurred in the second decade of life (85.4% vs 14.3%, 552 vs 92 stone events); chi-square test showed no significant association between gender/race and age group.
Conclusions: These findings demonstrate an alarming increase of symptomatic nephrolithiasis by 84.4% in the pediatric population at this location, establishing an increasing trend since 2006. Among demographic groups, white adolescent females have an increased risk of developing kidney stones.
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