Introduction: Current data suggests an increasing incidence in pediatric nephrolithiasis; however, there is a scarcity of data nationally across the United States, and little is known regarding the rate of increase. Here we report an alarming increase in symptomatic nephrolithiasis and ascertain future projection of stone disease in the pediatric population. Methods: A retrospective study was conducted via data collected from the Pediatric Health Information System (PHIS). Data was normalized according to time-adjusted hospital availability for national and AUA sub-section analysis (Fig. 1, 2). Only pediatric cases are considered and repeated visits within 93 days of presentation are excluded. Ordinary-Least-Squares (OLS) is performed via statsmodels in Python. ANOVA was implemented to determine significant differences in stone incidence between AUA sub-sections. Results: The PHIS yielded 36,496 (08/2004 to 09/2020) national visits of pediatric nephrolithiasis to the emergency department (ED). Following exclusion, 27,158 children (n=15,347, 56.5% female) with a median age of 15 yr. presented to PHIS hospital ED across the country for treatment of symptomatic nephrolithiasis. Our OLS analysis predicts an alarming rise in cases, with an estimated compound monthly growth rate of 0.011 cases (per hospital, per 31 days), nationally (Fig. 1, R2 = 0.609). Analysis of PHIS data according to AUA sub-sections identified statistically significant differences in stone disease between geographical regions of the U.S (Fig. 2b, c). We note a unanimous increase in incidence across all regions, with differing regional severities. Conclusions: With rising incidence of symptomatic pediatric nephrolithiasis and alarming projections of future increase across the U.S., it is imperative that pediatric urologists and the American Academy of Pediatrics formulate a working task force to address this rising prevalence of pediatric stone disease. SOURCE OF Funding: N/A
