Increasing prevalence of nephrolithiasis and BMI among children: a population base study

Epidemiological studies show an association of increased BMI with increased risk of kidney stone formation in adults. We conducted a population-based pediatric study to examine the epidemiology of nephrolithiasis in the Israeli pediatric population during a 30-year period, and to examine BMI distribution during the same period.

We accessed data from the compulsory medical evaluations of 17 year- olds in Israel, prior to their enlistment for military service during 1980-2013. Candidates for the army with a history of stone disease were compared to those without such history.

Of 1,908,893 candidates, 1691 reported a history of nephrolithiasis; this yields an average prevalence rate of 88.6 in 100.000. During 1980-1995, the average reported prevalence of nephrolithiasis was 69 cases per 100,000 candidates. From 1995, the reported prevalence increased by an average of 6% per year, and reached 120 per 100,000 during 2010-2012. This increased prevalence was observed for both males and females, but was more prominent among males. The mean BMI of stone formers was higher than that of the control group (22.7±3.5 vs. 22.1±3.9 kg/m2 p<0.001). The trend of increasing BMI among male candidates during 1995 to 2012 parallels the trend of increasing nephrolithiasis during these years. The odds ratio for nephrolithiasis in candidates with BMI>30 kg/m2 1.7 (1.4-2.1) compared to candidates with BMI 18.5-24.9 CONCLUSION: This large population-based study documents a rising prevalence of nephrolithiasis among children. The possible association of this finding with the rise in BMI during the same period warrants further investigation.

The Journal of urology. 2017 Oct 20 [Epub ahead of print]

Hadas Alfandary, Orly Haskin, Miriam Davidovits, Oren Pleniceanu, Adi Leiba, Amit Dagan

Institute of Nephrology, Schneider Children's Medical Center of Israel, Petach Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. Electronic address: ., Institute of Nephrology, Schneider Children's Medical Center of Israel, Petach Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel., Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; The Israel Defense Forces Medical Corps, Ramat Gan, Israel.