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Pediatric Nephrology

Published in:

01-05-2015 | Original Article

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

Authors: Kirsten Kusumi, Brian Becknell, Andrew Schwaderer

Published in: Pediatric Nephrology | Issue 5/2015

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.

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

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

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

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

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

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 183:1151–1156CrossRefPubMed

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

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

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

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 67:685–690CrossRefPubMed

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 64:402–410CrossRefPubMed

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 4:804–811CrossRefPubMedCentralPubMed

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 21:1641–1644CrossRefPubMedCentralPubMed

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 77:195–199CrossRefPubMed

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 74:104–107CrossRefPubMed

16.

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

17.

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

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 188:1618–1622CrossRefPubMedCentralPubMed

19.

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

20.

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

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 167:2372–2376CrossRefPubMed

22.

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

23.

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

24.

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

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 9:884–889CrossRefPubMed

26.

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

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 22:375–378CrossRefPubMed

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 15:125–128CrossRefPubMed

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 306:1136–1140CrossRefPubMed

30.

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

31.

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

32.

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

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 48:897–904CrossRefPubMed

34.

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

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 88:2076–2080CrossRefPubMed

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 11:7227–7236PubMed

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 143:487–495CrossRefPubMed

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 105:9841–9846CrossRefPubMedCentralPubMed

Title: Trends in pediatric urolithiasis: patient characteristics, associated diagnoses, and financial burden
Authors: Kirsten Kusumi
Brian Becknell
Andrew Schwaderer
Publication date: 01-05-2015
Publisher: Springer Berlin Heidelberg
Published in: Pediatric Nephrology / Issue 5/2015
Print ISSN: 0931-041X
Electronic ISSN: 1432-198X
DOI: https://doi.org/10.1007/s00467-014-3012-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

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

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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