Cao B. et al., 2023: Pediatric Nephrolithiasis

Tuesday, 11 July 2023

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Cao B, Daniel R, McGregor R, Tasian GE.
Department of Urology, College of Medicine, The University of Illinois, Chicago, IL 60612, USA.
Department of Medicine, The Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA.
Division of Urology, The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.

Abstract

The prevalence of pediatric nephrolithiasis has increased dramatically in the past two decades for reasons that have yet to be fully elucidated. Workup of pediatric kidney stones should include metabolic assessment to identify and address any risk factors predisposing patients to recurrent stone formation, and treatment should aim to facilitate stone clearance while minimizing complications, radiation and anesthetic exposure, and other risks. Treatment methods include observation and supportive therapy, medical expulsive therapy, and surgical intervention, with choice of treatment method determined by clinicians' assessments of stone size, location, anatomic factors, comorbidities, other risk factors, and preferences and goals of patients and their families. Much of the current research into nephrolithiasis is restricted to adult populations, and more data are needed to better understand many aspects of the epidemiology and treatment of pediatric kidney stones.
Healthcare (Basel). 2023 Feb 13;11(4):552. doi: 10.3390/healthcare11040552. PMID: 36833086. Review. FREE ARTICLE

Comments 1

Peter Alken on Tuesday, 11 July 2023 10:30

“When urolithiasis occurs in a child (an individual less than 18 years of age), this is known as pediatric urolithiasis.” (The present paper). I doubt that this is still a valid definition.

Here are three aspects on the question: What is a child?

1.) For the European Parliament “The voting age is 18 in all Member States except Austria and Malta, where it is 16, and Greece, where it is 17.” (https://www.europarl.europa.eu/factsheets/en/sheet/21/the-european-parliament-electoral-procedures)
People do not jump into adulthood at the age of 18 but their consciousness, behavior and habits change well before that time.

2.) This is a look at behavior and habits
Statistics from the EU show that in 2019, 37 % of the 15- to 16-year-olds in the EU experienced heavy episodic drinking at least once in the last 30 days. Germany is second best with 55% after Denmark with 59%.

From Health at a Glance: Europe 2022 (https://doi.org/10.1787/507433b0-en) and https://stat.link/z4m2t3

3.) “Prevalence of Childhood Obesity in the United States
Childhood obesity is a serious problem in the United States, putting children and adolescents at risk for poor health. …
Concerning “children and adolescents aged 2-19 years in 2017-20221, the prevalence of obesity was 19.7% and affected about 14.7 million children.
Obesity prevalence was 12.7% among 2- to 5-year-olds, 20.7% among 6- to 11-year-olds, and 22.2% among 12- to 19-year-olds.”
(From: https://www.cdc.gov/obesity/data/childhood.html)
It is well known, that the incidence of stone disease rises with the metabolic syndrome in “civilized countries” and age is no limit.

I think the urological standards concerning “childhood” have to be changed. Young ones are and behave like adults from an earlier age than 18. In children and adults, the physico-chemical principles of stone formation are identical and the treatment techniques are rather similar.
This paper with 162 references offers an extensive review of all aspects of urolithiasis in the young age groups

See also Smeulders N, et al. Shockwaves and the Rolling Stones: An Overview of Pediatric Stone Disease. Kidney Int Rep. 2022 Dec 2;8(2):215-228. doi: 10.1016/j.ekir.2022.11.017. eCollection 2023 Feb.PMID: 36815103. Review.
Free PMC article.

Peter Alken

“When urolithiasis occurs in a child (an individual less than 18 years of age), this is known as pediatric urolithiasis.” (The present paper). I doubt that this is still a valid definition.

Here are three aspects on the question: What is a child?

1.) For the European Parliament “The voting age is 18 in all Member States except Austria and Malta, where it is 16, and Greece, where it is 17.” (https://www.europarl.europa.eu/factsheets/en/sheet/21/the-european-parliament-electoral-procedures)
People do not jump into adulthood at the age of 18 but their consciousness, behavior and habits change well before that time.

2.) This is a look at behavior and habits
Statistics from the EU show that in 2019, 37 % of the 15- to 16-year-olds in the EU experienced heavy episodic drinking at least once in the last 30 days. Germany is second best with 55% after Denmark with 59%.
[img]https://www.storzmedical.com/images/blog/Cao.png[/img]
From Health at a Glance: Europe 2022 (https://doi.org/10.1787/507433b0-en) and https://stat.link/z4m2t3

3.) “Prevalence of Childhood Obesity in the United States
Childhood obesity is a serious problem in the United States, putting children and adolescents at risk for poor health. …
Concerning “children and adolescents aged 2-19 years in 2017-20221, the prevalence of obesity was 19.7% and affected about 14.7 million children.  
Obesity prevalence was 12.7% among 2- to 5-year-olds, 20.7% among 6- to 11-year-olds, and 22.2% among 12- to 19-year-olds.” 
(From: https://www.cdc.gov/obesity/data/childhood.html)
It is well known, that the incidence of stone disease rises with the metabolic syndrome in “civilized countries” and age is no limit.

I think the urological standards concerning “childhood” have to be changed. Young ones are and behave like adults from an earlier age than 18. In children and adults, the physico-chemical principles of stone formation are identical and the treatment techniques are rather similar.
This paper with 162 references offers an extensive review of all aspects of urolithiasis in the young age groups

See also Smeulders N, et al. Shockwaves and the Rolling Stones: An Overview of Pediatric Stone Disease. Kidney Int Rep. 2022 Dec 2;8(2):215-228. doi: 10.1016/j.ekir.2022.11.017. eCollection 2023 Feb.PMID: 36815103. Review.
 Free PMC article.

Peter Alken

“When urolithiasis occurs in a child (an individual less than 18 years of age), this is known as pediatric urolithiasis.” (The present paper). I doubt that this is still a valid definition. Here are three aspects on the question: What is a child? 1.) For the European Parliament “The voting age is 18 in all Member States except Austria and Malta, where it is 16, and Greece, where it is 17.” (https://www.europarl.europa.eu/factsheets/en/sheet/21/the-european-parliament-electoral-procedures) People do not jump into adulthood at the age of 18 but their consciousness, behavior and habits change well before that time. 2.) This is a look at behavior and habits Statistics from the EU show that in 2019, 37 % of the 15- to 16-year-olds in the EU experienced heavy episodic drinking at least once in the last 30 days. Germany is second best with 55% after Denmark with 59%. [img]https://www.storzmedical.com/images/blog/Cao.png[/img] From Health at a Glance: Europe 2022 (https://doi.org/10.1787/507433b0-en) and https://stat.link/z4m2t3 3.) “Prevalence of Childhood Obesity in the United States Childhood obesity is a serious problem in the United States, putting children and adolescents at risk for poor health. … Concerning “children and adolescents aged 2-19 years in 2017-20221, the prevalence of obesity was 19.7% and affected about 14.7 million children. Obesity prevalence was 12.7% among 2- to 5-year-olds, 20.7% among 6- to 11-year-olds, and 22.2% among 12- to 19-year-olds.” (From: https://www.cdc.gov/obesity/data/childhood.html) It is well known, that the incidence of stone disease rises with the metabolic syndrome in “civilized countries” and age is no limit. I think the urological standards concerning “childhood” have to be changed. Young ones are and behave like adults from an earlier age than 18. In children and adults, the physico-chemical principles of stone formation are identical and the treatment techniques are rather similar. This paper with 162 references offers an extensive review of all aspects of urolithiasis in the young age groups See also Smeulders N, et al. Shockwaves and the Rolling Stones: An Overview of Pediatric Stone Disease. Kidney Int Rep. 2022 Dec 2;8(2):215-228. doi: 10.1016/j.ekir.2022.11.017. eCollection 2023 Feb.PMID: 36815103. Review. Free PMC article. Peter Alken

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