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The Impact of Body Mass Index on Quantitative 24-h Urine Chemistries in Pediatric Urolithiasis: A Systematic Review
Jiao Zhong1, Bin Yang2, Yi Liu3
1Clinical Research and Translational Center, Second People's Hospital of Yibin City-West China Yibin Hospital, SichuanUniversity, Yibin, China, NO. 96 North Street, Cuiping District, Yibin, 644000, China.
Insights
Overweight and obese children with urolithiasis show increased uric acid in urine. However, body mass index (BMI) alone is not a definitive risk factor for pediatric kidney stones, as other urinary factors did not differ significantly.
Area of Science:
- Pediatric Nephrology
- Urology
- Metabolic Disorders
Background:
- Pediatric urolithiasis is a growing concern, with increasing prevalence linked to lifestyle factors.
- Body Mass Index (BMI) is a key indicator of nutritional status and a potential risk factor for various health conditions, including kidney stones.
Purpose of the Study:
- To investigate the impact of Body Mass Index (BMI) on 24-hour urine composition in children with urolithiasis.
- To determine if overweight and obesity contribute to the formation of urinary calculi in pediatric patients.
Main Methods:
- A systematic meta-analysis was conducted, including eight studies with 1033 children diagnosed with urolithiasis.
- Data on 24-hour urine quantitative analysis and BMI percentiles were extracted and analyzed using Stata14.0 software.
Main Results:
- Children with a BMI at or above the 85th percentile exhibited significantly higher uric acid excretion compared to their normal-weight counterparts (SMD = 0.756, P = .026).
- No statistically significant differences were observed in the excretion of calcium, 24-hour urine volume, magnesium, phosphate, oxalate, citrate, or sodium between the BMI groups.
- Sensitivity analyses confirmed the reliability of these findings.
Conclusions:
- Elevated urinary uric acid excretion is associated with overweight/obesity in children with urolithiasis.
- Despite this finding, BMI alone is not identified as a distinct and conclusive risk factor for pediatric urolithiasis due to the lack of significant differences in other critical urinary parameters.
Purpose:
To study the effect of body mass index (BMI) on 24-h urine quantitative analysis in pediatric urolithiasis, and to explore whether obesity and overweight promote the formation of urinary calculi in children.
Materials And Methods:
A comprehensive search of EMBASE, PubMed, the Cochrane Library, Web of Science, and Scopus was conducted in March 2024 and updated in October 2025 to identify all related studies. BMI was used to specify body size. Predetermined inclusion and exclusion criteria were used to screen each article. Data from appropriate studies were extracted, and a meta-analysis was performed using Stata 14.0 software.
Results:
Eight studies, including 1033 children with urolithiasis who underwent 24-h urine collection for chemical analysis, were included in this meta-analysis. The BMI ≥ 85th percentile group exhibited significantly higher uric acid excretion (SMD = 0.756, 95% CI = 0.092-1.420, P = .026). No statistically significant differences were found in calcium (SMD = -0.320, 95% CI = -0.600 to -0.050, P = .519), 24-h urine volume (SMD = -0.310, 95% CI = -0.790 to 0.160, P = .555), magnesium (SMD = -0.470, 95% CI = -0.820 to -0.120, P = .471), phosphate (SMD = -0.360, 95% CI = -0.610 to -0.110, P = .805), oxalate (SMD = -0.110, 95% CI = -0.390 to 0.170, P = .315), citrate (SMD = -0.190, 95% CI = -0.680 to 0.290, P = .057), or sodium (SMD = 0.200, 95% CI = -0.390 to 0.800, P = .050) excretion between the two groups. Sensitivity analyses confirmed the robustness of these findings.
Conclusion:
While overweight/obese children with urolithiasis demonstrate higher urinary uric acid excretion, the absence of significant differences in other key urinary risk factors suggests that BMI alone should not be considered a separate and definitive risk factor for pediatric urolithiasis.
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