Skip to main content

The Emergence of Kidney Stone Disease During Childhood—Impact on Adults

Current Urology Reports volume 18, Article number: 44 (2017) Cite this article

Abstract

Purpose of Review

The goal of this chapter is to review the recent epidemiologic trends of kidney stone disease and discuss the impact of the increasing incidence of nephrolithiasis among children on adults with respect to extra-renal manifestations, surgical management, and secondary prevention.

Recent Findings

Among pediatric patients, kidney stone disease has been increasing at a rate of approximately 5–10% annually. Kidney stone disease has been associated with increased risks of coronary heart disease, chronic kidney disease, hypertension, and decreased bone mineral density, which is concerning for patients diagnosed at a young age. Improvements in endo-urology have allowed for less invasive surgical treatment of stones in the pediatric population. However, current guidelines often lack recommendations for evaluation, medical, and surgical management of children with kidney stone disease.

Summary

Nephrolithiasis is a disorder of mineral metabolism, which is beginning during childhood with increasing frequency. Kidney stone disease often exists over the lifetime and is associated with serious conditions that are important for pediatric and adult urologists to recognize and consider in their evaluation and treatment of patients.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

43,34 €

Price includes VAT (Finland)
Tax calculation will be finalised during checkout.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Litwin MS, Saigal CS: Table 14–47: Economic impact of urologic disease. In: Urologic Diseases in America. NIH Publication 12–7865. Washington, DC, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Public Health Service, US Department of Health and Human Services, 2012, p 486.

  2. Saigal CS, Joyce G, Timilsina AR. Urologic diseases in America Project: direct and indirect costs of nephrolithiasis in an employed population: opportunity for disease management? Kidney Int. 2005;68:1808–14.

    Article  PubMed  Google Scholar 

  3. Ferraro PM, Taylor EN, Eisner BH, Gambaro G, Rimm EB, Mukamal KJ, Curhan GC. History of kidney stones and the risk of coronary heart disease. JAMA. 2013;310:408–15.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  4. Alexander RT, Hemmelgarn BR, Wiebe N, Bello A, Morgan C, Samuel S, Klarenbach SW, Curhan GC, Tonelli M. Alberta kidney disease network: kidney stones and kidney function loss: a cohort study. BMJ. 2012;345:e5287.

    Article  PubMed  PubMed Central  Google Scholar 

  5. • Denburg MR, Leonard MB, Haynes K, Tuchman S, Tasian G, Shults J, Copelovitch L. Risk of fracture in urolithiasis: a population-based cohort study using the health improvement network. Clin J Am Soc Nephrol. 2014;9:2133–40. This population-based cohort study demonstrated that urolithasis is associated with higher incident fracture risk among children and adults, with the greatest relative risk estimated for younger males and females. The greatest absolute risk of fracture was observed among women older than 60 years.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Stamatelou KK, Francis ME, Jones CA, Nyberg LM, Curhan GC. Time trends in reported prevalence of kidney stones in the United States: 1976-1994. Kidney Int. 2003;63:1817–23.

    Article  PubMed  Google Scholar 

  7. Scales Jr CD, Smith AC, Hanley JM, Saigal CS. Urologic diseases in America Project: prevalence of kidney stones in the United States. Eur Urol. 2012;62:160–5.

    Article  PubMed  PubMed Central  Google Scholar 

  8. • Tasian GE, Ross ME, Liahi S, Sas DJ, Keren R, Denburg MR, Chu DI, Copelovitch L, Saigal CS, Furth SL. Annual incidence of nephrolithiasis among children and adults in South Carolina from 1997 to 2012. CJASN. 2016;11(3):488–96. This population-based, repeated cross-sectional study demonstrated that the incidence of kidney stones increased 16% in the overall population in South Carolina over the 15-year period from 1997-2012. Disproportionate increases in the incidence of kidney stones were reported for adolescents (5% per year among 15-19 year olds), young adult women, and African Americans.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  9. Johnson CM, Wilson WM, O’Fallon DM, et al. Renal stone epidemiology: a 25-year study in Rochester Minnesota. Kidney Int. 1979;16:624–31.

    CAS  Article  PubMed  Google Scholar 

  10. Hiatt RA, Dales LG, Friedman GD, et al. Frequency of urolithiasis in a prepaid medical care program. Am J Epidemiol. 1982;115:255–265c.

    CAS  Article  PubMed  Google Scholar 

  11. Soucie JM, Coates RJ, McClellan W, et al. Relation between geographic variability in kidney stones prevalence and risk factors for stones. Am J Epidemiol. 1996;143:487–95.

    CAS  Article  PubMed  Google Scholar 

  12. Sarmina I, Spirnak JP. Urinary lithiasis in the black population: an epidemiological study and review of the literature. J Urol. 1987;138:14–7.

    CAS  PubMed  Google Scholar 

  13. Curhan GC, Rimm EB, Willett WC, et al. Regional variation in nephrolithiasis incidence and prevalence among United States men. J Urol. 1994;151:838–41.

    CAS  PubMed  Google Scholar 

  14. Kirejczyk JK, Porowski T, Filonowicz R, et al. An association between kidney stone composition and urinary metabolic disturbances in children. J Pediatr Urol. 2014;10:130.

    Article  PubMed  Google Scholar 

  15. •• Scales Jr CD, Tasian GE, Schwadere AL, Goldfarb DS, Star RA, Kirkali Z. Urinary stone disease: advancing knowledge, patient care, and population health. CJASN. 2016;11(7):1305–12. This comprehensive review conceptualizes urinary stone disease as a chronic metabolic condition (associated with decreased bone mineral density, cardiovascular disease and CKD) that is punctuated by symptomatic, preventable stone events. The authors emphasize that reducing the public health burden will require advances in understanding disease determinants and improving secondary prevention.

    Article  PubMed  Google Scholar 

  16. Sas DJ, Hulsey TC, Shatat IF, et al. Increasing incidence of kidney stones in children evaluated in the emergency department. J Pediatr. 2010;157:132.

    Article  PubMed  Google Scholar 

  17. Tanaka ST, Pope JC. IV pediatric stone disease. Curr Urol Rep. 2009;10:138.

    Article  PubMed  Google Scholar 

  18. Routh JC, Graham DA, Nelson CP. Epidemiological trends in urolithiasis at United States freestanding pediatric hospitals. J Urol. 2010;184:1100.

    Article  PubMed  Google Scholar 

  19. VanDervoort K, Wiesen J, Frank R, et al. Urolithiasis in pediatric patients: a single center study of incidence, clinical presentation and outcome. J Urol. 2007;177:2300.

    Article  PubMed  Google Scholar 

  20. Frush DP. Pediatric dose reduction in computed tomography. Health Phys. 2008;95:518.

    CAS  Article  PubMed  Google Scholar 

  21. Smith RC, Verga M, McCarthy S, et al. Diagnosis of acute flank pain: value of unenhanced helical CT. AJR. 1996;166:97.

    CAS  Article  PubMed  Google Scholar 

  22. Palmer JS, Donaher ER, O’Riordan MA, et al. Diagnosis of pediatric urolithiasis: role of ultrasound and computed tomography. J Urol. 2005;174:1413.

    Article  PubMed  Google Scholar 

  23. Oner S, Oto A, Tekgul S, et al. Comparison of spiral CT and the US in the evaluation of pediatric urolithiasis. JBR-BTR. 2004;87:219.

    CAS  PubMed  Google Scholar 

  24. Routh JC, Graham DA, Nelson CP. Trends in imaging and surgical management of pediatric urolithiasis at American pediatric hospitals. J Urol. 184:1816.

  25. Tasian GE, Pulido JE, Keren R, Dick AW, Setodji CM, Hanley JM, Madison R, Saigal CS. Use of and regional variation in initial CT imaging for kidney stones. Pediatrics. 2014;134(5):909–15.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Ogden CL, Carroll MD, Flegal KM. High body mass index for age among US children and adolescents, 2003–2006. JAMA. 2008;299:2401.

    CAS  Article  PubMed  Google Scholar 

  27. Kieran K, Giel DW, Morris BJ, et al. Pedatric urolithiasis: does body mass index influence stone presentation and treatment? J Urol. 2010;184:1810.

    Article  PubMed  Google Scholar 

  28. Dwyer ME, Krambeck AE, Bergstralh EJ, Milliner DS, Lieske JC, Rule AD. Temporal trends in the incidence of kidney stones among children: a 25-year population-based study. J Urol. 2012;188(1):247–52.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Ljunghall S, Danielson BG. A prospective study of renal stone recurrences. Br J Urol. 1984;56:122.

    CAS  Article  PubMed  Google Scholar 

  30. Tasian GE, Kabarriti AE, Kalmus A, Furth SL. Kidney stone recurrence among children and adolescents. J Urol. 2016.

  31. Diamond DA, Menon M, Lee PH, et al. Etiological factors in pediatric stone recurrence. J Urol. 1989;142:606.

    CAS  PubMed  Google Scholar 

  32. Pietrow PK, Pope JC, Adams MC, et al. Clinical outcome of pediatric stone disease. JURO. 2001;167:670.

    Google Scholar 

  33. Lao M, Kogan BA, White MD, et al. High recurrence rate at 5-year followup in children after upper urinary tract stone surgery. J Urol. 2014;191:440.

    Article  PubMed  Google Scholar 

  34. Cauley JA, Fullman RL, Stone KL, Zmuda JM, Bauer DC, Barrett-Connor E, Ensrud K, Lau EM, Orwoll ES. Mr. OS research group: factors associated with the lumbar spine and proximal femur bone mineral density in older men. Osteoporos Int. 2005;16:1525–37.

    Article  PubMed  Google Scholar 

  35. Jaeger P, Lippuner K, Casez JP, Hess B, Ackermann D, Hug C. Low bone mass in idiopathic renal stone formers: magnitude and significance. J Bone Miner Res. 1994;9:1525–32.

    CAS  Article  PubMed  Google Scholar 

  36. Lawoyin S, Sismilich S, Browne R, Pak CY. Bone mineral content in patients with calcium urolithiasis. Metabolism. 1979;28:1250–4.

    CAS  Article  PubMed  Google Scholar 

  37. Pietschmann F, Breslau NA, Pak CY. Reduced vertebral bone density in hypercalciuric nephrolithiasis. J Bone Miner Res. 1992;7:1383–8.

    CAS  Article  PubMed  Google Scholar 

  38. Schwaderer AL, Kusumi K, Ayoob RM. Pediatric nephrolithiasis and the link to bone metabolism. Curr Opin Pediatr. 2014;26(2):207–14.

    CAS  Article  PubMed  Google Scholar 

  39. Srivastava T, Schwaderer A. Diagnosis and management of hypercalciuria in children. Curr Opin Pediatr. 2009;21(2):214–9.

    Article  PubMed  Google Scholar 

  40. Schwaderer AL, Srivastava T, Schueller L, Cronin R, Mahan JD, Hains D. Dietary modifications alone do not improve bone mineral density in children with idiopathic hypercalciuria. Clin Nephrol. 2011 Nov;76(5):341–7.

    CAS  Article  PubMed  Google Scholar 

  41. Madore F, Stampfer MJ, Rimm EB, et al. Nephrolithiasis and risk of hypertension. Am J Hypertens. 1998;11:46–53.

    CAS  Article  PubMed  Google Scholar 

  42. Madore F, Stampfer MJ, Willett WC, et al. Nephrolithiasis and risk of hypertension in women. Am J Kidney Dis. 1998;32:802–7.

    CAS  Article  PubMed  Google Scholar 

  43. •• Denburg MR, Jemielita TA, Tasian GE, Haynes K, Mucksavage P, Shults J, Copelovitch L. Assessing the risk of incident hypertension and chronic kidney disease after exposure to shockwave lithotripsy and ureteroscopy. Kidney Int. 2015. This population-based cohort study demonstrated a higher risk of hypertension among patients who underwent shockwave lithotripsy (SWL) for kidney stones. Considering the known poor efficacy of SWL for large stones, this study adds evidence against the guideline that SWL be considered an option for children with kidney stones >2cm.

  44. Obligado SH, Goldfarb DS. The association of nephrolithiasis with hypertension and obesity: a review. Am J Hypertens. 2008;21:257–64.

    CAS  Article  PubMed  Google Scholar 

  45. Saad KS, Youssif ME, Hamdy SA, Fahmy A, El Din Hanno AG, El-Nahas AR. Percutaneous nephrolithotomy vs retrograde intrarenal surgery for large renal stones in pediatric patients: a randomized controlled trial. J Urol. 2015;194(6):1716–20.

    Article  PubMed  Google Scholar 

  46. Ishii H, Griffin S, Somani BK. Flexible ureteroscopy and lasertripsy (FURSL) for paediatric renal calculi: results from a systematic review. J Pediatr Urol. 2014;10(6):1020–5.

    CAS  Article  PubMed  Google Scholar 

  47. Alexander CE, Gowland S, Cadwalader J, Reynard JM, Turney BW. Shockwave lithotripsy (SWL): outcomes from a national SWL database in New Zealand. BJUI. April 2016;117(S4):76–81.

    Article  Google Scholar 

  48. AUA guidelines: Surgical Management of Stones: American Urological Association/Endourological Society Guideline. 2016.

  49. Pearle MS, Goldfarb DS, Assimos DG, Curhan G, Denu-Ciocca CJ, Matlaga BR, Monga M, Penniston KL, Preminger GM, Turk TM, White JR. American Urological Association: medical management of kidney stones: AUA guideline. J Urol. 2014;192:316–24.

    Article  PubMed  Google Scholar 

  50. Skolarikos A, Straub M, Knoll T, Sarica K, Seitz C, Petrik A, Turk C. Metabolic evaluation and recurrence prevention for urinary stone patients: EAU guidelines. Eur Urol. 2015;67:750–63.

    Article  PubMed  Google Scholar 

  51. Qaseem A, Dallas P, Forciea MA, Starkey M, Denberg TD. Clinical guidelines Committee of the American College of physicians: dietary and pharmacologic management to prevent recurrent nephrolithiasis in adults: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2014;161:659–67.

    Article  PubMed  Google Scholar 

  52. Cheungpasitporn W, Rossetti S, Friend K, Erickson SB, Lieske JC. Treatment effect, adherence, and safety of high fluid intake for the prevention of incident and recurrent kidney.

  53. Turk C, Petrik A, Sarica K, Seitz C, Skolarikos A, Straub M, Knoll T. EAU guidelines on intervenional treatment for urolithiasis. Eur Urol. 2016;69:475–82.

    Article  PubMed  Google Scholar 

  54. Ziemba JB, Matlaga BR. Guideline of guidelines: kidney stones. BJU Int. 2015;116:184–9.

    Article  PubMed  Google Scholar 

  55. Borghi L, Meschi T, Amato F, Briganti A, Novarini A, Giannini A. Urinary volume, water and recurrences in idiopathic calcium nephrolithiasis: a 5-year randomized prospective study. J Urol. 1996;155:839–43.

    CAS  Article  PubMed  Google Scholar 

Download references

Author information

Affiliations

  1. Department of Surgery, Division of Urology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA

    Jeremy R. Bonzo & Gregory E. Tasian

  2. Department of Surgery, Division of Pediatric Urology, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Gregory E. Tasian

  3. Center for Pediatric Clinical Effectiveness, The Children’s Hospital Of Philadelphia, Philadelphia, PA, USA

    Gregory E. Tasian

  4. Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA

    Gregory E. Tasian

  5. Department of Biostatistics and Epidemiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA

    Gregory E. Tasian

  6. Division of Urology, Children’s Hospital of Philadelphia, 34th Street and Civic Center Boulevard, Wood Center, 3rd Floor, Philadelphia, PA, 19104, USA

    Gregory E. Tasian

Authors
  1. Jeremy R. Bonzo
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Gregory E. Tasian
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Gregory E. Tasian.

Ethics declarations

Conflict of Interest

Jeremy R. Bonzo declares no potential conflicts of interest.

Gregory E. Tasian reports grants from NIH-NIDDK (K23DK106428) and personal fees from Allena Pharmaceuticals.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

This article is part of the Topical Collection on Endourology

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Bonzo, J.R., Tasian, G.E. The Emergence of Kidney Stone Disease During Childhood—Impact on Adults. Curr Urol Rep 18, 44 (2017). https://doi.org/10.1007/s11934-017-0691-x

Download citation

  • Published:

  • DOI: https://doi.org/10.1007/s11934-017-0691-x

Keywords

  • Nephrolithiasis
  • Children
  • Extrarenal manifestations
  • Stone prevention
  • Transition of care