Epidemiology and risk factors for urolithiasis in children

Objective Pediatric urolithiasis is a growing global health concern, characterized by increasing incidence and recurrence rates. It differs from adult stone disease because of its strong association with metabolic abnormalities, genetic predispositions, and anatomical anomalies, which necessitate lifelong follow-up and tailored interventions. This review aimed to present a comprehensive overview of the epidemiology, metabolic etiologies, and risk factors contributing to pediatric stone formation, with an emphasis on recent advances in understanding and management. Methods A synthesis of current literature was conducted, focusing on epidemiological data, etiological mechanisms, and metabolic abnormalities contributing to stone formation in children. Relevant studies, case series, and case reports published in peer-reviewed journals were analyzed to explore the underlying pathophysiological processes, with particular attention to diagnostic approaches and therapeutic strategies employed in the affected pediatric population. Results Pediatric stone disease accounts for approximately 3% of all urolithiasis cases. Calcium oxalate remains the most prevalent stone type, while hypercalciuria is the leading metabolic abnormality. Other significant risk factors include hypocitraturia, hyperoxaluria, hyperuricosuria, and cystinuria. Urinary tract infections caused by urease-producing bacteria contribute to the formation of infection-related stones. Genetic mutations have been identified in monogenic forms of the disease, especially in recurrent or early-onset cases. Factors such as low fluid intake, high-salt or -oxalate diets, and underlying anatomical anomalies also increase the risk of stone formation. Conclusion Pediatric urolithiasis is a multifactorial and often recurrent condition that requires early diagnosis and individualized management strategies. Identifying metabolic and genetic risk factors is essential to prevent renal damage and recurrence. Ongoing research into the pathogenesis of pediatric stones is critical to developing targeted prevention and treatment approaches.