, Volume 44, Issue 3, pp 241–246 | Cite as

Clinical, demographic, and laboratory characteristics of children with nephrolithiasis

  • David J. Sas
  • Lauren J. Becton
  • Jeffrey Tutman
  • Laura A. Lindsay
  • Amy H. Wahlquist
Original Paper


While the incidence of pediatric kidney stones appears to be increasing, little is known about the demographic, clinical, laboratory, imaging, and management variables in this patient population. We sought to describe various characteristics of our stone-forming pediatric population. To that end, we retrospectively reviewed the charts of pediatric patients with nephrolithiasis confirmed by imaging. Data were collected on multiple variables from each patient and analyzed for trends. For body mass index (BMI) controls, data from the general pediatrics population similar to our nephrolithiasis population were used. Data on 155 pediatric nephrolithiasis patients were analyzed. Of the 54 calculi available for analysis, 98 % were calcium based. Low urine volume, elevated supersaturation of calcium phosphate, elevated supersaturation of calcium oxalate, and hypercalciuria were the most commonly identified abnormalities on analysis of 24-h urine collections. Our stone-forming population did not have a higher BMI than our general pediatrics population, making it unlikely that obesity is a risk factor for nephrolithiasis in children. More girls presented with their first stone during adolescence, suggesting a role for reproductive hormones contributing to stone risk, while boys tended to present more commonly at a younger age, though this did not reach statistical significance. These intriguing findings warrant further investigation.


Nephrolithiasis Urolithiasis Kidney stones Pediatrics Obesity Adolescents 

Supplementary material

240_2015_827_MOESM1_ESM.docx (11 kb)
Reference ranges for 24-hour urine samples (from Litholink Corporation, Chicago, IL unless referenced otherwise) (DOCX 11 kb)


  1. 1.
    Bush NC, Xu L, Brown BJ, Holzer MS, Gingrich A, Schuler B, Tong L, Baker LA (2010) Hospitalizations for pediatric stone disease in United States, 2002–2007. J Urol 183(3):1151–1156. doi:10.1016/j.juro.2009.11.057 CrossRefPubMedGoogle Scholar
  2. 2.
    Dwyer ME, Krambeck AE, Bergstralh EJ, Milliner DS, Lieske JC, Rule AD (2012) Temporal trends in incidence of kidney stones among children: a 25-year population based study. J Urol 188(1):247–252. doi:10.1016/j.juro.2012.03.021 CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Routh JC, Graham DA, Nelson CP (2010) Epidemiological trends in pediatric urolithiasis at United States freestanding pediatric hospitals. J Urol 184(3):1100–1104. doi:10.1016/j.juro.2010.05.018 CrossRefPubMedGoogle Scholar
  4. 4.
    Sas DJ, Hulsey TC, Shatat IF, Orak JK (2010) Incidence of kidney stones in children evaluated in the ER is increasing. J PediatricsGoogle Scholar
  5. 5.
    Gillen DL, Coe FL, Worcester EM (2005) Nephrolithiasis and increased blood pressure among females with high body mass index. Am J Kidney Dis 46(2):263–269. doi:10.1053/j.ajkd.2005.04.030 CrossRefPubMedGoogle Scholar
  6. 6.
    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(2):685–690. doi:10.1111/j.1523-1755.2005.67128.x CrossRefPubMedGoogle Scholar
  7. 7.
    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 CJASN 4(4):804–811. doi:10.2215/CJN.05811108 CrossRefPubMedGoogle Scholar
  8. 8.
    Worcester EM, Parks JH, Evan AP, Coe FL (2006) Renal function in patients with nephrolithiasis. J Urol 176(2):600–603. doi:10.1016/j.juro.2006.03.095 (discussion-603) CrossRefPubMedGoogle Scholar
  9. 9.
    Pietrow PK, Pope JCT, Adams MC, Shyr Y, Brock JW 3rd (2002) Clinical outcome of pediatric stone disease. J Urol 167(2 Pt 1):670–673CrossRefPubMedGoogle Scholar
  10. 10.
    Sas DJ (2011) An update on the changing epidemiology and metabolic risk factors in pediatric kidney stone disease. Clin J Am Soc Nephrol CJASN 6(8):2062–2068. doi:10.2215/CJN.11191210 CrossRefPubMedGoogle Scholar
  11. 11.
    Battino BS, De FW, Coe F, Tackett L, Erhard M, Wacksman J, Sheldon CA, Minevich E (2002) Metabolic evaluation of children with urolithiasis: are adult references for supersaturation appropriate? J Urol 168(6):2568–2571 (pii:S0022-5347(05)64217-6) CrossRefPubMedGoogle Scholar
  12. 12.
    Matos V, Van Melle G, Werner D, Bardy D, Guignard JP (1999) Urinary oxalate and urate to creatinine ratios in a healthy pediatric population. Am J Kidney Dis Off J Nat Kidney Foundation 34(2):e1. doi:10.1053/AJKD034000e6 CrossRefGoogle Scholar
  13. 13.
    Penido MG, Srivastava T, Alon US (2013) Pediatric primary urolithiasis: 12-year experience at a Midwestern Children’s Hospital. J Urol 189(4):1493–1497. doi:10.1016/j.juro.2012.11.107 CrossRefPubMedGoogle Scholar
  14. 14.
    Alon US (2009) Medical treatment of pediatric urolithiasis. Pediatric Nephrol 24(11):2129–2135. doi:10.1007/s00467-007-0740-7 CrossRefGoogle Scholar
  15. 15.
    Matos V, van Melle G, Boulat O, Markert M, Bachmann C, Guignard JP (1997) Urinary phosphate/creatinine, calcium/creatinine, and magnesium/creatinine ratios in a healthy pediatric population. J Pediatrics 131(2):252–257CrossRefGoogle Scholar
  16. 16.
    Milliner DS, Murphy ME (1993) Urolithiasis in pediatric patients. Mayo Clin Proc 68(3):241–248CrossRefPubMedGoogle Scholar
  17. 17.
    Maalouf NM, Sakhaee K, Parks JH, Coe FL, Adams-Huet B, Pak CY (2004) Association of urinary pH with body weight in nephrolithiasis. Kidney Int 65(4):1422–1425. doi:10.1111/j.1523-1755.2004.00522.x CrossRefPubMedGoogle Scholar
  18. 18.
    Taylor EN, Stampfer MJ, Curhan GC (2005) Obesity, weight gain, and the risk of kidney stones. JAMA 293(4):455–462. doi:10.1001/jama.293.4.455 CrossRefPubMedGoogle Scholar
  19. 19.
    Ayoob R, Wang W, Schwaderer A (2011) Body fat composition and occurrence of kidney stones in hypercalciuric children. Pediatr Nephrol 26(12):2173–2178. doi:10.1007/s00467-011-1927-5 CrossRefPubMedGoogle Scholar
  20. 20.
    Kim SS, Luan X, Canning DA, Landis JR, Keren R (2011) Association between body mass index and urolithiasis in children. J Urol 186(4 Suppl):1734–1739. doi:10.1016/j.juro.2011.04.009 CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    Eisner BH, Eisenberg ML, Stoller ML (2009) Influence of Body Mass Index on Quantitative 24-Hour Urine Chemistry Studies in Children With Nephrolithiasis. J Urol. doi:10.1016/j.juro.2009.05.052 Google Scholar
  22. 22.
    Sarica K, Eryildirim B, Yencilek F, Kuyumcuoglu U (2009) Role of overweight status on stone-forming risk factors in children: a prospective study. Urology 73(5):1003–1007. doi:10.1016/j.urology.2008.11.038 CrossRefPubMedGoogle Scholar
  23. 23.
    Daudon M, Lacour B, Jungers P (2006) Influence of body size on urinary stone composition in men and women. Urol Res 34(3):193–199. doi:10.1007/s00240-006-0042-8 CrossRefPubMedGoogle Scholar
  24. 24.
    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(1):104–107. doi:10.1016/j.urology.2008.12.079 CrossRefPubMedGoogle Scholar
  25. 25.
    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(3):979–982. doi:10.1016/j.juro.2006.10.069 CrossRefPubMedGoogle Scholar
  26. 26.
    Maalouf NM, Sato AH, Welch BJ, Howard BV, Cochrane BB, Sakhaee K, Robbins JA (2010) Postmenopausal hormone use and the risk of nephrolithiasis: results from the Women’s Health Initiative hormone therapy trials. Arch Intern Med 170(18):1678–1685. doi:10.1001/archinternmed.2010.342 CrossRefPubMedPubMedCentralGoogle Scholar
  27. 27.
    Fan J, Chandhoke PS, Grampsas SA (1999) Role of sex hormones in experimental calcium oxalate nephrolithiasis. J Am Soc Nephrol 10(Suppl 14):S376–S380PubMedGoogle Scholar
  28. 28.
    Iguchi M, Takamura C, Umekawa T, Kurita T, Kohri K (1999) Inhibitory effects of female sex hormones on urinary stone formation in rats. Kidney Int 56(2):479–485. doi:10.1046/j.1523-1755.1999.00586.x CrossRefPubMedGoogle Scholar
  29. 29.
    Dey J, Creighton A, Lindberg JS, Fuselier HA, Kok DJ, Cole FE, Hamm L (2002) Estrogen replacement increased the citrate and calcium excretion rates in postmenopausal women with recurrent urolithiasis. J Urol 167(1):169–171CrossRefPubMedGoogle Scholar
  30. 30.
    Heller HJ, Sakhaee K, Moe OW, Pak CY (2002) Etiological role of estrogen status in renal stone formation. J Urol 168(5):1923–1927. doi:10.1097/01.ju.0000033907.21910.be CrossRefPubMedGoogle Scholar
  31. 31.
    Spivacow FR, Negri AL, del Valle EE, Calvino I, Fradinger E, Zanchetta JR (2008) Metabolic risk factors in children with kidney stone disease. Pediatr Nephrol 23(7):1129–1133. doi:10.1007/s00467-008-0769-2 CrossRefPubMedGoogle Scholar
  32. 32.
    VanDervoort K, Wiesen J, Frank R, Vento S, Crosby V, Chandra M, Trachtman H (2007) Urolithiasis in pediatric patients: a single center study of incidence, clinical presentation and outcome. J Urol 177(6):2300–2305. doi:10.1016/j.juro.2007.02.002 CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • David J. Sas
    • 1
  • Lauren J. Becton
    • 2
  • Jeffrey Tutman
    • 3
  • Laura A. Lindsay
    • 4
  • Amy H. Wahlquist
    • 5
  1. 1.Division of Pediatric Nephrology and Hypertension, Department of Pediatric and Adolescent MedicineMayo ClinicRochesterUSA
  2. 2.Division of Pediatric Nephrology, Department of PediatricsAlbert Einstein School of MedicineBronxUSA
  3. 3.University of Utah Department of RadiologySalt Lake CityUSA
  4. 4.Children’s Emergency ServicesDayton Children’s HospitalDaytonUSA
  5. 5.Division of Biostatistics and Epidemiology, Department of MedicineMedical University of South CarolinaCharlestonUSA

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