Dietary Risk Factors for Pediatric Kidney Stones:... : Journal of Urology (original) (raw)

Dietary Risk Factors for Pediatric Kidney Stones: A Case-Control Study

Journal of Urology

208

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2

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434

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440

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August 2022

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| DOI: 10.1097/JU.0000000000002687

Purpose:

Data are scarce regarding dietary risk factors for pediatric nephrolithiasis. Our objective was to perform a case-control study (nonmatched) of the association of dietary nutrients with pediatric urolithiasis.

Materials and Methods:

We obtained dietary information from pediatric urolithiasis patients (from stone clinic in 2013–2016) and healthy controls (well-child visit at primary care in 2011–2012). Survey results were converted to standard nutrient intakes. Children younger than 5 years of age and those with extreme calorie intake values (<500 or >5,000 kcal/day) were excluded. The association of individual nutrients with urolithiasis was assessed by bivariate analysis results and machine-learning methods. A multivariable logistic regression model was fitted using urolithiasis as the outcome.

Results:

We included 285 patients (57 stones/228 controls). Mean±SD age was 8.9±3.6 years (range 5–20). Of the patients 47% were male. After adjusting for age, sex, body mass index (obese/overweight/normal), calorie intake and oxalate, urolithiasis was associated with higher dietary sodium (OR=2.43 [95% CI=1.40–4.84] per quintile increase, p=0.004), calcium (OR=1.73 [95% CI=1.07–3.00] per quintile increase, p=0.034) and beta carotene (OR=2.01 [95% CI=1.06–4.18] per quintile increase, p=0.042), and lower potassium (OR=0.31 [95% CI=0.13–0.63] per quintile increase, p=0.003). Sensitivity analysis was performed by removing oxalate from the model and limiting the sample to patients aged 5–13 years, with similar results.

Conclusions:

In our cohort, higher dietary intake of calcium, sodium and beta carotene, and lower potassium intake were associated with pediatric urolithiasis. This is the first study using a detailed dietary survey to identify dietary risk factors for pediatric urolithiasis. Further research is warranted to delineate the mechanisms and to generate a lower risk diet profile for pediatric urolithiasis.