Incidence of kidney stone disease in Icelandic children and adolescents from 1985 to 2013: results of a nationwide study
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.
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.
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.
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.
KeywordsKidney stones Nephrolithiasis Urolithiasis Epidemiology
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.
- 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.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
- 38.Steingrimsdottir LT, Thorgeirsdottir H, Olafsdottir AS (2003) (The Icelandic National Nutrition Survey 2002). https://www.landlaeknir.is/servlet/file/store93/item11603/skyrsla.pdf