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High incidence of kidney stones in Icelandic children
Vidar Edvardsson1, Helga Elidottir, Olafur S Indridason
1Department of Pediatrics, Landspitali University Hospital, Hringbraut, 101 Reykjavik, Iceland.
Insights
Pediatric kidney stones are common in Iceland, with metabolic risk factors found in most cases. This study highlights a high incidence in children, particularly females, emphasizing the need for further research into underlying causes.
Area of Science:
- Pediatric Nephrology
- Urology
- Epidemiology
Background:
- Kidney stones (nephrolithiasis) affect children, with varying incidence globally.
- Understanding pediatric kidney stone epidemiology in specific populations is crucial for public health.
- Icelandic pediatric kidney stone data is limited, necessitating focused research.
Purpose of the Study:
- To determine the incidence and characteristics of first-episode kidney stones in children in Iceland.
- To identify associated clinical features, risk factors, and outcomes in pediatric kidney stone patients.
- To compare the incidence of pediatric kidney stones in Iceland with other Western populations.
Main Methods:
- Retrospective study of children (<18 years) diagnosed with kidney stones between 1995-2000 in Icelandic pediatric centers.
- Diagnosis confirmed via clinical features and imaging studies.
- Patient evaluation included clinical assessment, urinalysis, urine culture, and metabolic workup.
Main Results:
- The annual incidence was 5.6 per 100,000 children (<18 years).
- Abdominal pain and hematuria were the most common symptoms (69% and 80.8%, respectively).
- Metabolic risk factors, primarily hypercalciuria (78%), were identified in 96% of evaluated patients.
Conclusions:
- The incidence of pediatric kidney stones in Iceland is high compared to other Western countries, with a higher prevalence in females.
- Metabolic abnormalities are prevalent in children with kidney stones, indicating a significant role in stone formation.
- Further investigation into the etiology and prevention of pediatric kidney stones in Iceland is warranted.
Abstract:
All children less than 18 years of age who were diagnosed with a first episode of kidney stones at pediatric referral centers in Iceland during the years 1995-2000 were studied retrospectively. The diagnosis was based on clinical features and results of imaging studies. Patients were invited for evaluation at the end of the study period. Twenty-six patients (15 females, 11 males), median age 9.4 (range 0.2-14.9) years, experienced 34 episodes of kidney stones. The annual incidence was 5.6 and 6.3 per 100,000 children less than 18 and 16 years of age, respectively. Abdominal pain was the most common symptom (N=17; 69%) and urinalysis revealed hematuria in 21 patients (80.8%), sterile pyuria in 17 (65%), and 2,8-dihydroxyadeninuria in two. Six patients (23%) had positive urine cultures at the time of diagnosis and five (20%) had urinary tract anomalies. Family history of kidney stones was positive in one third of patients. Metabolic risk factors for stone formation were identified in 22 of 23 patients (96%) who underwent evaluation. Hypercalciuria, the most common metabolic risk factor, was identified in 18 patients (78%). Stones passed spontaneously in nine patients (35%) and six patients had recurrent stone episodes. The incidence of kidney stones in Icelandic children is high compared with other Western populations, affecting females more than males. Underlying metabolic risk factors were identified in most patients.
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