68 INCIDENCE OF RENAL STONES AMONG CHILDREN: A 25-YEAR POPULATION-BASED STUDY

You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Practice Patterns, Cost Effectiveness1 Apr 201168 INCIDENCE OF RENAL STONES AMONG CHILDREN: A 25-YEAR POPULATION-BASED STUDY Moira Dwyer, Amy Krambeck, Eric Bergstralh, Dawn Milliner, John Lieske, and Andrew Rule Moira DwyerMoira Dwyer Rochester, MN More articles by this author , Amy KrambeckAmy Krambeck Rochester, MN More articles by this author , Eric BergstralhEric Bergstralh Rochester, MN More articles by this author , Dawn MillinerDawn Milliner Rochester, MN More articles by this author , John LieskeJohn Lieske Rochester, MN More articles by this author , and Andrew RuleAndrew Rule Rochester, MN More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.132AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Population-based estimates of the temporal trends in renal stones among children are needed. We conducted such a study to determine the incidence of renal stones by age, gender, and calendar year over a 25-year period. METHODS The Rochester Epidemiology Project was used to identify all children diagnosed with renal stones (ICD9 codes 592, 594, and 274.11) from ages 0–17 years in Olmsted County, Minnesota from 1984–2008. Medical records were reviewed to validate incident symptomatic renal stones, which required age-appropriate symptoms and evidence of stone on an imaging study or with passage. Incidence was estimated per 100,000 person-years of risk standardized to the 2000 United States Census age-sex distribution. Age, gender, and calendar year differences in the incidence of renal stones were assessed with Poisson regression. RESULTS There were 207 children who received a diagnostic code for renal stones; 84 (41%) were valid incident stone-formers. Of the remainder, 41% (84) were not stone-formers, 7% (14) were suspect stone-formers lacking confirmatory clinical or imaging evidence of stone, 7% (14) were asymptomatic stone-formers, 3% (7) refused research authorization, and 2% (4) were stone-formers prior to residency in the county. Stone incidence rates in girls and boys were, respectively, 13 (95% CI: 9 to 16) and 9 (95% CI: 6 to 11) per 100,000 person-years (p=0.08); incidence was higher for patients aged 12–17 (p<0.001). Overall incidence increased 4% per year (p=0.01), attributable to rising incidence in the 12–17 year-old cohort (p=0.02 for age x time period interaction) (Figure 1). From 1984–1996, computed tomography (CT) was the stone-identifying imaging study in 0/18 of these adolescents whereas, after 1996, CT diagnosed 79% (44/56) of stones in this age group. Calcium oxalate monohydrate was found in 72% (26/36) of stones. Median stone diameter on imaging was 3 mm (range 1–20, n=67). Surgery occurred in 29% (24/84) of patients. CONCLUSIONS The incidence of renal stones in Olmsted County has recently doubled among adolescents while remaining stable in younger age groups. The impact of trends in CT usage on the increasing incidence of stones diagnosed in the adolescent population remains to be determined. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e29-e30 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Moira Dwyer Rochester, MN More articles by this author Amy Krambeck Rochester, MN More articles by this author Eric Bergstralh Rochester, MN More articles by this author Dawn Milliner Rochester, MN More articles by this author John Lieske Rochester, MN More articles by this author Andrew Rule Rochester, MN More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...