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Shockwaves and the Rolling Stones: An Overview of Pediatric Stone Disease
Naima Smeulders1, Alexander Cho1, Abdulelah Alshaiban1,2
1Great Ormond Street Hospital National Health Service Foundation Trust, London, UK.
Insights
Urinary stone disease is rare in children but requires specialized care. Adult treatment approaches are not suitable for pediatric urolithiasis, necessitating a multidisciplinary strategy.
Area of Science:
- Pediatric Urology
- Nephrology
- Pediatric Nephrology
Background:
- Urinary stone disease affects 10-20% of adults, with a 1% annual incidence.
- Pediatric urolithiasis is rare but increasing, with an incidence of 5-36 per 100,000 children.
- Rare disease complications like delayed diagnosis and limited specialist knowledge impact pediatric stone cases.
Purpose of the Study:
- To review the epidemiology, etiology, presentation, investigation, and management of pediatric stone disease.
- To highlight differences between pediatric and adult stone disease management.
- To advocate for a specialized, multidisciplinary approach to pediatric urolithiasis.
Main Methods:
- Literature review on pediatric urolithiasis.
- Comparative analysis of adult versus pediatric stone disease.
- Synthesis of current evidence for management strategies.
Main Results:
- Pediatric urolithiasis presents unique challenges compared to adult cases.
- Adult treatment protocols are often inappropriate for children.
- Specialized knowledge and multidisciplinary care are crucial for effective pediatric stone management.
Conclusions:
- Pediatric stone disease requires distinct management strategies.
- A specialized, multidisciplinary approach is essential for optimal outcomes in children.
- Further research and dedicated pediatric services are needed.
Abstract:
Urinary stone disease is a common problem in adults, with an estimated 10% to 20% lifetime risk of developing a stone and an annual incidence of almost 1%. In contrast, in children, even though the incidence appears to be increasing, urinary tract stones are a rare problem, with an estimated incidence of approximately 5 to 36 per 100,000 children. Consequently, typical complications of rare diseases, such as delayed diagnosis, lack of awareness, and specialist knowledge, as well as difficulties accessing specific treatments also affect children with stone disease. Indeed, because stone disease is such a common problem in adults, frequently, it is adult practitioners who will first be asked to manage affected children. Yet, there are unique aspects to pediatric urolithiasis such that treatment practices common in adults cannot necessarily be transferred to children. Here, we review the epidemiology, etiology, presentation, investigation, and management of pediatric stone disease; we highlight those aspects that separate its management from that in adults and make a case for a specialized, multidisciplinary approach to pediatric stone disease.
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