Skip to main content

Advertisement

Log in

Trends in pediatric urolithiasis: patient characteristics, associated diagnoses, and financial burden

  • Original Article
  • Published:
Pediatric Nephrology Aims and scope Submit manuscript

Abstract

Background

The goal of this study was to examine national trends in hospitalization, emergency department (ED) utilization, secondary diagnoses, and charges associated with pediatric urolithiasis.

Methods

Data were evaluated from the Kids’ Inpatient Database of the Healthcare Costs and Utilization Project (HCUP) database from 1997 to 2012 and the HCUP National ED Sample from 2006 to 2011.

Results

Pediatric nephrolithiasis discharges increased by 18 %, while ureterolithiasis discharges decreased by 17 %. Hospital charges increased by 20 % when accounting for inflation, despite an overall decrease in discharges by 2.5 %. Female patients and those aged 15–17 years were more commonly affected. Pediatric ED visits increased by 9 %. The most common secondary diagnoses during 2003–2009 were urinary tract infections (UTI) (13 %), asthma (9 %), epilepsy (4 %), and paralysis (4 %).

Conclusions

Decreased hospitalizations and increased ED visits indicate a shift to outpatient care. Inpatient health care charges associated with pediatric urolithiasis continue to rise. Comorbidities include UTI, asthma, epilepsy, attention deficit hyperactivity disorder (ADHD), and mood disorders. Because of the significant health care burden and the increased risk to children of developing long-term sequelae there is a strong need for increased research into the mechanism of this systemic inflammatory disease and improved therapeutic targets.

This is a preview of subscription content, log in via an institution to check access.

Access this article

We’re sorry, something doesn't seem to be working properly.

Please try refreshing the page. If that doesn't work, please contact support so we can address the problem.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Moe OW (2006) Kidney stones: pathophysiology and medical management. Lancet 367:333–344

    Article  CAS  PubMed  Google Scholar 

  2. Coe FL, Parks JH, Asplin JR (1992) The pathogenesis and treatment of kidney stones. N Engl J Med 327:1141–1152

    Article  CAS  PubMed  Google Scholar 

  3. Scales CD Jr, Curtis LH, Norris RD, Springhart WP, Sur RL, Schulman KA, Preminger GM (2007) Changing gender prevalence of stone disease. J Urol 177:979–982

    Article  PubMed  Google Scholar 

  4. Lotan Y (2009) Economics and cost of care of stone disease. Adv Chronic Kidney Dis 16:5–10

    Article  PubMed  Google Scholar 

  5. Sas DJ, Hulsey TC, Shatat IF, Orak JK (2010) Increasing incidence of kidney stones in children evaluated in the emergency department. J Pediatr 157:132–137

    Article  PubMed  Google Scholar 

  6. Bush NC, Xu L, Brown BJ, Holzer MS, Gingrich A, Schuler B, Tong LY, Baker LA (2010) Hospitalizations for pediatric stone disease in United States, 2002–2007. J Urol 183:1151–1156

    Article  PubMed  Google Scholar 

  7. Routh JC, Graham DA, Nelson CP (2010) Epidemiological trends in pediatric urolithiasis at United States freestanding pediatric hospitals. J Urol 184:1100–1104

    Article  PubMed  Google Scholar 

  8. Matlaga BR, Schaeffer AJ, Novak TE, Trock BJ (2010) Epidemiologic insights into pediatric kidney stone disease. Urol Res 38:453–457

    Article  PubMed  Google Scholar 

  9. Pearle MS, Calhoun EA, Curhan GC (2005) Urologic diseases in America project: urolithiasis. J Urol 173:848–857

    Article  PubMed  Google Scholar 

  10. Gillen DL, Worcester EM, Coe FL (2005) Decreased renal function among adults with a history of nephrolithiasis: a study of NHANES III. Kidney Int 67:685–690

    Article  PubMed  Google Scholar 

  11. Liu Y, Li S, Zeng Z, Wang J, Xie L, Li T, He Y, Qin X, Zhao J (2014) Kidney stones and cardiovascular risk: a meta-analysis of cohort studies. Am J Kidney Dis 64:402–410

    Article  PubMed  Google Scholar 

  12. Rule AD, Bergstralh EJ, Melton LJ 3rd, Li X, Weaver AL, Lieske JC (2009) Kidney stones and the risk for chronic kidney disease. Clin J Am Soc Nephrol 4:804–811

    Article  PubMed Central  PubMed  Google Scholar 

  13. Rule AD, Roger VL, Melton LJ 3rd, Bergstralh EJ, Li X, Peyser PA, Krambeck AE, Lieske JC (2010) Kidney stones associate with increased risk for myocardial infarction. J Am Soc Nephrol 21:1641–1644

    Article  PubMed Central  PubMed  Google Scholar 

  14. Schaeffer AJ, Feng Z, Trock BJ, Mathews RI, Neu AM, Gearhart JP, Matlaga BR (2011) Medical comorbidities associated with pediatric kidney stone disease. Urology 77:195–199

    Article  PubMed  Google Scholar 

  15. Novak TE, Lakshmanan Y, Trock BJ, Gearhart JP, Matlaga BR (2009) Sex prevalence of pediatric kidney stone disease in the United States: an epidemiologic investigation. Urology 74:104–107

    Article  PubMed  Google Scholar 

  16. Obligado SH, Goldfarb DS (2008) The association of nephrolithiasis with hypertension and obesity: a review. Am J Hypertens 21:257–264

    Article  CAS  PubMed  Google Scholar 

  17. Flegal KM, Tabak CJ, Ogden CL (2006) Overweight in children: definitions and interpretation. Health Educ Res 21:755–760

    Article  PubMed  Google Scholar 

  18. Kokorowski PJ, Routh JC, Hubert KC, Graham DA, Nelson CP (2012) Association of urolithiasis with systemic conditions among pediatric patients at children’s hospitals. J Urol 188:1618–1622

    Article  PubMed Central  PubMed  Google Scholar 

  19. Taylor EN, Stampfer MJ, Curhan GC (2005) Obesity, weight gain, and the risk of kidney stones. JAMA 293:455–462

    Article  CAS  PubMed  Google Scholar 

  20. Heller HJ, Sakhaee K, Moe OW, Pak CY (2002) Etiological role of estrogen status in renal stone formation. J Urol 168:1923–1927

    Article  CAS  PubMed  Google Scholar 

  21. Bergsland KJ, Kinder JM, Asplin JR, Coe BJ, Coe FL (2002) Influence of gender and age on calcium oxalate crystal growth inhibition by urine from relatives of stone forming patients. J Urol 167:2372–2376

    Article  CAS  PubMed  Google Scholar 

  22. Pietrow PK, Pope JCT, Adams MC, Shyr Y, Brock JW 3rd (2002) Clinical outcome of pediatric stone disease. J Urol 167:670–673

    Article  PubMed  Google Scholar 

  23. Borghi L, Nouvenne A, Meschi T (2012) Nephrolithiasis and urinary tract infections: ‘the chicken or the egg’ dilemma? Nephrol Dial Transplant 27:3982–3984

    Article  PubMed  Google Scholar 

  24. Welch BJ, Graybeal D, Moe OW, Maalouf NM, Sakhaee K (2006) Biochemical and stone-risk profiles with topiramate treatment. Am J Kidney Dis 48:555–563

    Article  CAS  PubMed  Google Scholar 

  25. Corbin Bush N, Twombley K, Ahn J, Oliveira C, Arnold S, Maalouf NM, Sakhaee K (2013) Prevalence and spot urine risk factors for renal stones in children taking topiramate. J Pediatr Urol 9:884–889

    Article  PubMed  Google Scholar 

  26. Israni RK, Kasbekar N, Haynes K, Berns JS (2006) Use of antiepileptic drugs in patients with kidney disease. Semin Dial 19:408–416

    Article  PubMed  Google Scholar 

  27. Sampath A, Kossoff EH, Furth SL, Pyzik PL, Vining EP (2007) Kidney stones and the ketogenic diet: risk factors and prevention. J Child Neurol 22:375–378

    Article  PubMed  Google Scholar 

  28. Furth SL, Casey JC, Pyzik PL, Neu AM, Docimo SG, Vining EP, Freeman JM, Fivush BA (2000) Risk factors for urolithiasis in children on the ketogenic diet. Pediatr Nephrol 15:125–128

    Article  CAS  PubMed  Google Scholar 

  29. Stewart AF, Adler M, Byers CM, Segre GV, Broadus AE (1982) Calcium homeostasis in immobilization: an example of resorptive hypercalciuria. N Engl J Med 306:1136–1140

    Article  CAS  PubMed  Google Scholar 

  30. Craven BL, Passman C, Assimos DG (2008) Hypercalcemic states associated with nephrolithiasis. Rev Urol 10:218–226

    PubMed Central  PubMed  Google Scholar 

  31. Cury DB, Moss AC, Schor N (2013) Nephrolithiasis in patients with inflammatory bowel disease in the community. Int J Nephrol Renovasc Dis 6:139–142

    Article  PubMed Central  PubMed  Google Scholar 

  32. Clark JH, Fitzgerald JF, Bergstein JM (1985) Nephrolithiasis in childhood inflammatory bowel disease. J Pediatr Gastroenterol Nutr 4:829–834

    Article  CAS  PubMed  Google Scholar 

  33. Lieske JC, de la Vega LS, Gettman MT, Slezak JM, Bergstralh EJ, Melton LJ 3rd, Leibson CL (2006) Diabetes mellitus and the risk of urinary tract stones: a population-based case-control study. Am J Kidney Dis 48:897–904

    Article  PubMed  Google Scholar 

  34. Taylor EN, Stampfer MJ, Curhan GC (2005) Diabetes mellitus and the risk of nephrolithiasis. Kidney Int 68:1230–1235

    Article  PubMed  Google Scholar 

  35. Faggiano A, Pivonello R, Melis D, Filippella M, Di Somma C, Petretta M, Lombardi G, Colao A (2003) Nephrolithiasis in Cushing’s disease: prevalence, etiopathogenesis, and modification after disease cure. J Clin Endocrinol Metab 88:2076–2080

    Article  CAS  PubMed  Google Scholar 

  36. Danese S, Semeraro S, Papa A, Roberto I, Scaldaferri F, Fedeli G, Gasbarrini G, Gasbarrini A (2005) Extraintestinal manifestations in inflammatory bowel disease. World J Gastroenterol 11:7227–7236

    PubMed  Google Scholar 

  37. Soucie JM, Coates RJ, McClellan W, Austin H, Thun M (1996) Relation between geographic variability in kidney stones prevalence and risk factors for stones. Am J Epidemiol 143:487–495

    Article  CAS  PubMed  Google Scholar 

  38. Brikowski TH, Lotan Y, Pearle MS (2008) Climate-related increase in the prevalence of urolithiasis in the United States. Proc Natl Acad Sci U S A 105:9841–9846

    Article  PubMed Central  CAS  PubMed  Google Scholar 

Download references

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Andrew Schwaderer.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kusumi, K., Becknell, B. & Schwaderer, A. Trends in pediatric urolithiasis: patient characteristics, associated diagnoses, and financial burden. Pediatr Nephrol 30, 805–810 (2015). https://doi.org/10.1007/s00467-014-3012-3

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00467-014-3012-3

Keywords

Navigation