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Pediatric urolithiasis associated with acute gastroenteritis: an inpatient database study in Japan
Masato Takeuchi1,2, Hideo Yasunaga3,4, Hiroki Matsui3,4
1Department of Pediatrics, Kikkoman General Hospital, 100 Miyazaki, Noda, Chiba, 278-0005, Japan. takeuchi.masato.3c@kyoto-u.ac.jp.
Insights
Pediatric urolithiasis risk doubles with acute gastroenteritis (AGE) in hospitalized children, though the overall incidence remains low. This study highlights various pathogens causing AGE-related kidney stones with generally favorable outcomes.
Area of Science:
- Pediatric Nephrology
- Infectious Diseases
- Urology
Background:
- Pediatric urolithiasis (kidney stones) linked to acute gastroenteritis (AGE) lacks systematic investigation.
- Existing reports are sporadic, primarily from Japan, with unclear epidemiology.
Purpose of the Study:
- To investigate the prevalence, risk, and outcomes of pediatric urolithiasis associated with AGE.
- To determine the association between AGE and the risk of developing urolithiasis in children.
Main Methods:
- Utilized a Japanese national inpatient database.
- Analyzed data for children (≤59 months) hospitalized for AGE over a 24-month period.
- Identified cases of urolithiasis among the AGE cohort.
Main Results:
- Found 23 cases of urolithiasis among 62,800 children hospitalized for AGE (3.7 cases/10,000 admissions).
- AGE was associated with a significant twofold increased risk of urolithiasis (OR 2.01, p=0.015).
- Common AGE pathogens included rotavirus, norovirus, and bacteria; most patients had favorable outcomes.
Conclusions:
- Childhood AGE doubles the risk of urolithiasis in hospitalized patients, but the absolute risk is low.
- AGE-related urolithiasis can be caused by diverse pathogens, with generally positive patient outcomes.
- Findings contrast with previous reports, emphasizing the need for awareness of this association.
Abstract:
Pediatric urolithiasis associated with acute gastroenteritis (AGE) has not been systematically investigated, including its prevalence, risk estimate, and outcome. Using a national inpatient database in Japan, we searched for children (≤59 months old) who were hospitalized for AGE and those complicated by urolithiasis over a 24-month period. We found 23 cases of urolithiasis among 62,800 children who were hospitalized for AGE (3.7 cases/10,000 AGE admissions). AGE was associated with an increased risk of urolithiasis (odds ratio 2.01; p = 0.015). The patients' mean age was 24 months and there was male dominance. Four patients had chronic medical conditions, including two with renal conditions. None of the patients had congenital metabolic disorders. Nine patients had causative agents for AGE, including rotavirus (n = 5), norovirus (n = 2), and bacteria (n = 2). Two patients required placement of a nephrostomy tube and the remaining 21 patients were discharged without invasive procedures.
Conclusion:
Childhood AGE is associated with a twofold risk of urolithiasis in a hospitalized cohort, but the absolute risk is low. Our study shows that AGE-related urolithiasis occurs through a variety of pathogens, and the outcomes of patients are favorable, which is in contrast to previous reports. What is Known: • There are several sporadic reports of pediatric urolithiasis associated with acute gastroenteritis (AGE), predominantly from Japan. • The epidemiology of AGE-related urolithiasis is however unclear. What is New: • AGE is associated with a two-fold risk of urolithiasis in a hospitalized cohort, with its absolute risk of 3.7 cases/10,000 AGE admissions.
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