Masato Takeuchi1,2, Hideo Yasunaga3,4, Hiroki Matsui3,4, Kiyohide Fushimi3,5. 1. Department of Pediatrics, Kikkoman General Hospital, 100 Miyazaki, Noda, Chiba, 278-0005, Japan. takeuchi.masato.3c@kyoto-u.ac.jp. 2. Department of Pediatrics, The University of Tokyo, Tokyo, Japan. takeuchi.masato.3c@kyoto-u.ac.jp. 3. Department of Pediatrics, The University of Tokyo, Tokyo, Japan. 4. Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan. 5. Department of Health Policy and Informatics, Tokyo Medical and Dental University Graduate School, Tokyo, Japan.
Abstract
Pediatric urolithiasis associated with acute gastroenteritis (AGE) has not been systematically investigated, including its prevalence, risk estimate, and outcome. Using a national inpatient database in Japan, we searched for children (≤59 months old) who were hospitalized for AGE and those complicated by urolithiasis over a 24-month period. We found 23 cases of urolithiasis among 62,800 children who were hospitalized for AGE (3.7 cases/10,000 AGE admissions). AGE was associated with an increased risk of urolithiasis (odds ratio 2.01; p = 0.015). The patients' mean age was 24 months and there was male dominance. Four patients had chronic medical conditions, including two with renal conditions. None of the patients had congenital metabolic disorders. Nine patients had causative agents for AGE, including rotavirus (n = 5), norovirus (n = 2), and bacteria (n = 2). Two patients required placement of a nephrostomy tube and the remaining 21 patients were discharged without invasive procedures. CONCLUSION: Childhood AGE is associated with a twofold risk of urolithiasis in a hospitalized cohort, but the absolute risk is low. Our study shows that AGE-related urolithiasis occurs through a variety of pathogens, and the outcomes of patients are favorable, which is in contrast to previous reports. What is Known: • There are several sporadic reports of pediatric urolithiasis associated with acute gastroenteritis (AGE), predominantly from Japan. • The epidemiology of AGE-related urolithiasis is however unclear. What is New: • AGE is associated with a two-fold risk of urolithiasis in a hospitalized cohort, with its absolute risk of 3.7 cases/10,000 AGE admissions.
Pediatric urolithiasis associated with acute gastroenteritis (AGE) has not been systematically investigated, including its prevalence, risk estimate, and outcome. Using a national inpatient database in Japan, we searched for children (≤59 months old) who were hospitalized for AGE and those complicated by urolithiasis over a 24-month period. We found 23 cases of urolithiasis among 62,800 children who were hospitalized for AGE (3.7 cases/10,000 AGE admissions). AGE was associated with an increased risk of urolithiasis (odds ratio 2.01; p = 0.015). The patients' mean age was 24 months and there was male dominance. Four patients had chronic medical conditions, including two with renal conditions. None of the patients had congenital metabolic disorders. Nine patients had causative agents for AGE, including rotavirus (n = 5), norovirus (n = 2), and bacteria (n = 2). Two patients required placement of a nephrostomy tube and the remaining 21 patients were discharged without invasive procedures. CONCLUSION: Childhood AGE is associated with a twofold risk of urolithiasis in a hospitalized cohort, but the absolute risk is low. Our study shows that AGE-related urolithiasis occurs through a variety of pathogens, and the outcomes of patients are favorable, which is in contrast to previous reports. What is Known: • There are several sporadic reports of pediatric urolithiasis associated with acute gastroenteritis (AGE), predominantly from Japan. • The epidemiology of AGE-related urolithiasis is however unclear. What is New: • AGE is associated with a two-fold risk of urolithiasis in a hospitalized cohort, with its absolute risk of 3.7 cases/10,000 AGE admissions.