Abstract: TH-PO1089

Increasing Prevalence of Nephrolithiasis Correlating with an Increase in BMI – A Population Based Study of Israeli Children

Session Information

Category: Mineral Disease

  • 1204 Mineral Disease: Nephrolithiasis

Authors

  • Alfandary, Hadas, Schneider Children's medical center of Israel, Petah Tiqva, Israel
  • Haskin, Orly, Schneider Children's medical center of Israel, Petah Tiqva, Israel
  • Davidovits, Miriam, Schneider Children's Medical Center of Israel, Petah Tiqva, Israel
  • Pleniceanu, Oren, Pediatric stem cell research institute, Sheba medical center, Petach Tqiwa, Israel
  • Leiba, Adi, None, Ramat Gan, Israel
  • Dagan, Amit, Schneider Children's medical center of Israel, Petah Tiqva, Israel
Background

Studies of adult and pediatric populations have shown a significant rise in nephrolithiasis incidence in recent decades. In adults, a clear association has been demonstrated between increasing BMI and a higher risk of kidney stone formation. Evidence is less conclusive for the pediatric population. This study examined the epidemiology of nephrolithiasis in the Israeli pediatric population during a 30-year period

Methods

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

Results

Of 1,908,893 candidates, 1691 reported a history of nephrolithiasis before the age of 18 years; this yields an average incidence rate of 88.6 in 100.000. During 1980-1995 the average reported incidence of nephrolithiasis was 69 cases per 100,000 candidates. From 1995, reported incidence increased by an average of 6% per year, and reached 120 per 100,000 during 2010-2012. This increased incidence 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 odds ratio for nephrolithiasis in candidates with BMI 25-30 kg/m2 was 1.3 (1.1-1.5) and for BMI>30 kg/m2, it reached 1.7 (1.4-2.1) compared to the control group (table 1).
The trend of increasing BMI among male candidates during 1995 to 2012 parallels the trend of increasing reports of nephrolithiasis during these years, r=0.71 p<0.01

Conclusion

In conclusion, our study is the largest population based epidemiological analysis on nephrolithiasis in children. We were able to show that in the last 20 years the incidence of nephrolithiasis in children has risen significantly. In our study population males had higher rates of nephrolithiasis than did females, with no change in the difference between the genders in the last 20 years. We report a correlation between increasing BMI and increasing prevalence of nephrolithiasis in children. More prospective observational and intervention studies are needed to examine a pathophysiological explanation linking high BMI with nephrolithiasis