Incidence of kidney stone disease in Icelandic children and adolescents from 1985 to 2013: results of a nationwide study

  • Vidar O. Edvardsson
  • Solborg E. Ingvarsdottir
  • Runolfur Palsson
  • Olafur S. Indridason
Original Article

Abstract

Background

An increase in the incidence of kidney stone disease has been reported for all age groups worldwide. To examine this trend, we conducted a nationwide study of the epidemiology of kidney stones in Icelandic children and adolescents over a 30-year period.

Methods

Computerized databases of all major hospitals and medical imaging centers in Iceland were searched for International Classification of Diseases and radiologic and surgical procedure codes indicative of kidney stones in patients aged < 18 years, followed by a thorough medical record review. Age-adjusted incidence was calculated for the time intervals 1985–1989, 1990–1994, 1995–1999, 2000–2004, 2005–2009, and 2010–2013. Time trends in stone incidence were assessed by Poisson regression. The prevalence of stone disease for the years 1999–2013 was also determined.

Results

Almost all the 190 patients (97%) that we identified had symptomatic stones, and acute flank or abdominal pain and hematuria were the most common presenting features. The total annual incidence of kidney stones increased from 3.7/100,000 in the first 5-year interval to 11.0/100,000 during the years 1995–2004 (p < 0.001) and decreased thereafter to 8.7/100,000 in 2010–2013 (p = 0.63). The incidence rise was highest in girls aged 13–17 years, in whom it rose from 9.8/100,000 in 1985–1989 to 39.2/100,000 in 2010–2013 (p < 0.001), resulting in an overall female predominance in this age group. The mean annual prevalence of stone disease in 1999–2013 was 48/100,000 for boys and 52/100,000 for girls.

Conclusion

We found a significant increase in the incidence of childhood kidney stone disease, driven by a dramatic increase of stone frequency in teenage females which is poorly understood and warrants further study.

Keywords

Kidney stones Nephrolithiasis Urolithiasis Epidemiology 

Notes

Acknowledgements

Preliminary results of this study appeared in an abstract form at the Biennial Meeting of The Icelandic Society of Internal Medicine in Reykjavik in October 2010, and the Annual Meeting of The American Society of Nephrology in Denver, CO, USA, in November 2010. The authors want to thank Loftur Ingi Bjarnason, Computer Scientist at Landspitali–The National University Hospital of Iceland, for data management and programming.

Compliance with ethical standards

The study was approved by the Icelandic National Bioethics Committee (NBC 03-002-S1-AG1) and the Icelandic Data Protection Authority. The work described has been carried out in accordance with the Code of Ethics of the World Medical Association (Declaration of Helsinki).

Conflict of interest

The authors declare that they have no conflict of interest.

References

  1. 1.
    Stamatelou KK, Francis ME, Jones CA, Nyberg LM, Curhan GC (2003) Time trends in reported prevalence of kidney stones in the United States: 1976-1994. Kidney Int 63:1817–1823CrossRefPubMedGoogle Scholar
  2. 2.
    Romero V, Akpinar H, Assimos DG (2010) Kidney stones: a global picture of prevalence, incidence, and associated risk factors. Rev Urol 12:e86–e96PubMedPubMedCentralGoogle Scholar
  3. 3.
    Edvardsson VO, Indridason OS, Haraldsson G, Kjartansson O, Palsson R (2013) Temporal trends in the incidence of kidney stone disease. Kidney Int 83:146–152CrossRefPubMedGoogle Scholar
  4. 4.
    Trinchieri A, Coppi F, Montanari E, Del Nero A, Zanetti G, Pisani E (2000) Increase in the prevalence of symptomatic upper urinary tract stones during the last ten years. Eur Urol 37:23–25CrossRefPubMedGoogle Scholar
  5. 5.
    Du J, Johnston R, Rice M (2009) Temporal trends of acute nephrolithiasis in Auckland, New Zealand. N Z Med J 122:13–20PubMedGoogle Scholar
  6. 6.
    Yasui T, Iguchi M, Suzuki S, Kohri K (2008) Prevalence and epidemiological characteristics of urolithiasis in Japan: national trends between 1965 and 2005. Urology 71:209–213CrossRefPubMedGoogle Scholar
  7. 7.
    Sas DJ, Hulsey TC, Shatat IF, Orak JK (2010) Increasing incidence of kidney stones in children evaluated in the emergency department. J Pediatr 157:132–137CrossRefPubMedGoogle Scholar
  8. 8.
    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 188:247–252CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    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 177:2300–2305CrossRefPubMedGoogle Scholar
  10. 10.
    Matlaga BR, Schaeffer AJ, Novak TE, Trock BJ (2010) Epidemiologic insights into pediatric kidney stone disease. Urol Res 38(6):453–457CrossRefPubMedGoogle Scholar
  11. 11.
    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 74:104–107CrossRefPubMedGoogle Scholar
  12. 12.
    Pietrow PK, Pope JCI, Adams MC, Shyr Y, Brock JWI (2002) Clinical outcome of pediatric stone disease. J Urol 167:670–673CrossRefPubMedGoogle Scholar
  13. 13.
    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 183:1151–1156CrossRefPubMedGoogle Scholar
  14. 14.
    Bergsland KJ, Coe FL, White MD, Erhard MJ, DeFoor WR, Mahan JD, Schwaderer AL, Asplin JR (2012) Urine risk factors in children with calcium kidney stones and their siblings. Kidney Int 81:1140–1148CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Edvardsson V, Elidottir H, Indridason OS, Palsson R (2005) High incidence of kidney stones in Icelandic children. Pediatr Nephrol 20:940–944CrossRefPubMedGoogle Scholar
  16. 16.
    Coe FL, Parks JH, Asplin JR (1992) The pathogenesis and treatment of kidney stones. N Engl J Med 327:1141–1152CrossRefPubMedGoogle Scholar
  17. 17.
    Milliner DS, Murphy ME (1993) Urolithiasis in pediatric patients. Mayo Clin Proc 68:241–248CrossRefPubMedGoogle Scholar
  18. 18.
    Coward RJM, Peters CJ, Duffy PG, Corry D, Kellett MJ, Choong S, van't Hoff WG (2003) Epidemiology of paediatric renal stone disease in the UK. Arch Dis Child 88:962–965CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    Bevill M, Kattula A, Cooper CS, Storm DW (2016) The modern metabolic stone evaluation in children. Urology 101:15–20CrossRefPubMedGoogle Scholar
  20. 20.
    Edvardsson VO, Goldfarb DS, Lieske JC, Beara-Lasic L, Anglani F, Milliner DS, Palsson R (2013) Hereditary causes of kidney stones and chronic kidney disease. Pediatr Nephrol 28:1923–1942CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    Cochat P, Pichault V, Bacchetta J, Dubourg L, Sabot JF, Saban C, Daudon M, Liutkus A (2010) Nephrolithiasis related to inborn metabolic diseases. Pediatr Nephrol 25:415–424CrossRefPubMedGoogle Scholar
  22. 22.
    Edvardsson V (2016) Urolithiasis in children. In: Avner ED et al (eds) Pediatric Nephrology. Springer, Berlin, pp 1821–1868CrossRefGoogle Scholar
  23. 23.
    Penido MG, Srivastava T, Alon US (2013) Pediatric primary urolithiasis: 12-year experience at a Midwestern Children’s Hospital. J Urol 189:1493–1497CrossRefPubMedGoogle Scholar
  24. 24.
    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 168:2568–2571CrossRefPubMedGoogle Scholar
  25. 25.
    Lande MB, Varade W, Erkan E, Niederbracht Y, Schwartz GJ (2005) Role of urinary supersaturation in the evaluation of children with urolithiasis. Pediatr Nephrol 20:491–494CrossRefPubMedGoogle Scholar
  26. 26.
    Pak CY, Poindexter JR, Adams-Huet B, Pearle MS (2003) Predictive value of kidney stone composition in the detection of metabolic abnormalities. Am J Med 115:26–32CrossRefPubMedGoogle Scholar
  27. 27.
    Levy FL, Adams-Huet B, Pak CY (1995) Ambulatory evaluation of nephrolithiasis: an update of a 1980 protocol. Am J Med 98:50–59CrossRefPubMedGoogle Scholar
  28. 28.
    Kuczmarski RJ, Ogden CL, Grummer-Strawn LM, Flegal KM, Guo SS, Wei R, Mei Z, Curtin LR, Roche AF, Johnson CL (2000) CDC Growth Charts: United States. Adv Data 314:1-27 Google Scholar
  29. 29.
    Ogden CL, Kuczmarski RJ, Flegal KM, Mei Z, Guo S, Wei R, Grummer-Strawn LM, Curtin LR, Roche AF, Johnson CL (2002) Centers for Disease Control and Prevention 2000 growth charts for the United States: improvements to the 1977 National Center for Health Statistics version. Pediatrics 109:45–60CrossRefPubMedGoogle Scholar
  30. 30.
    Scales CD Jr, Smith AC, Hanley JM, Saigal CS, Urologic Diseases in America Project (2012) Prevalence of kidney stones in the United States. Eur Urol 62:160–165CrossRefPubMedPubMedCentralGoogle Scholar
  31. 31.
    Routh JC, Graham DA, Nelson CP (2010) Epidemiological trends in pediatric urolithiasis at United States freestanding pediatric hospitals. J Urol 184:1100–1104CrossRefPubMedGoogle Scholar
  32. 32.
    Ramello A, Vitale C, Marangella M (2000) Epidemiology of nephrolithiasis. J Nephrol 13(Suppl 3):S45–S50PubMedGoogle Scholar
  33. 33.
    Soucie JM, Thun MJ, Coates RJ, McClellan W, Austin H (1994) Demographic and geographic variability of kidney stones in the United States. Kidney Int 46:893–899CrossRefPubMedGoogle Scholar
  34. 34.
    Lieske JC, Pena de la Vega LS, Slezak JM, Bergstralh EJ, Leibson CL, Ho KL, Gettman MT (2006) Renal stone epidemiology in Rochester, Minnesota: an update. Kidney Int 69:760–764CrossRefPubMedGoogle Scholar
  35. 35.
    Tefekli A, Esen T, Ziylan O, Erol B, Armagan A, Ander H, Akinci M (2003) Metabolic risk factors in pediatric and adult calcium oxalate urinary stone formers: is there any difference? Urol Int 70:273–277CrossRefPubMedGoogle Scholar
  36. 36.
    Peres LA, Langer SS, Schmidt RC, Nacke RA, Francescon PV, Almeida RC, Coimbra RM, Ribas TM, Barros TD, Matsuo T (2011) Nephrolithiasis in pediatric patients: metabolic and anatomical investigation. J Bras Nefrol 33:50–54CrossRefPubMedGoogle Scholar
  37. 37.
    Elmaci AM, Ece A, Akin F (2014) Clinical characteristics and metabolic abnormalities in preschool-age children with urolithiasis in southeast Anatolia. J Pediatr Urol 10:495–499CrossRefPubMedGoogle Scholar
  38. 38.
    Steingrimsdottir LT, Thorgeirsdottir H, Olafsdottir AS (2003) (The Icelandic National Nutrition Survey 2002). https://www.landlaeknir.is/servlet/file/store93/item11603/skyrsla.pdf
  39. 39.
    Gunnarsdottir I, Helgadottir H, Thorisdottir B, Thorsdottir I (2013) (Diet of six-year-old Icelandic children—national dietary survey 2011-2012). Laeknabladid 99:17–23PubMedGoogle Scholar
  40. 40.
    Taylor EN, Fung TT, Curhan GC (2009) DASH-style diet associates with reduced risk for kidney stones. J Am Soc Nephrol 20:2253–2259CrossRefPubMedPubMedCentralGoogle Scholar
  41. 41.
    Borghi L, Schianchi T, Meschi T, Guerra A, Allegri F, Maggiore U, Novarini A (2002) Comparison of two diets for the prevention of recurrent stones in idiopathic hypercalciuria. N Engl J Med 346:77–84CrossRefPubMedGoogle Scholar
  42. 42.
    Helgason A, Nicholson G, Stefansson K, Donnelly P (2003) A reassessment of genetic diversity in Icelanders: strong evidence from multiple loci for relative homogeneity caused by genetic drift. Ann Hum Genet 67:281–297CrossRefPubMedGoogle Scholar

Copyright information

© IPNA 2018

Authors and Affiliations

  • Vidar O. Edvardsson
    • 1
    • 2
  • Solborg E. Ingvarsdottir
    • 1
    • 2
  • Runolfur Palsson
    • 1
    • 3
  • Olafur S. Indridason
    • 3
  1. 1.Faculty of Medicine, School of Health SciencesUniversity of IcelandReykjavikIceland
  2. 2.Children’s Medical CenterLandspitali–The National University Hospital of IcelandReykjavikIceland
  3. 3.Division of Nephrology, Internal Medicine ServicesLandspitali–The National University Hospital of IcelandReykjavikIceland

Personalised recommendations