Association between body mass index, urine metabolic disturbances, and nephrolithiasis in pediatric patients.

BACKGROUND

The link between obesity, urine metabolic disturbances, and the development of kidney stones in children and adolescents remains controversial.

OBJECTIVES

The objective of this work is to identify the association between BMI, urine metabolic disturbance, and pediatric nephrolithiasis.

DATA SOURCES: PubMed, Embase, Web of Science, Cochrane Library, and Scopus databases were searched from inception to June 30, 2023.

STUDY ELIGIBILITY CRITERIA: Case-control, cohort, and cross-sectional studies with nephrolithiasis in patients aged 21 years or younger, with the topic of BMI and urine metabolic disruption were included.

PARTICIPANTS AND INVENTIONS: Children and adolescents with nephrolithiasis are the participants.

STUDY APPRAISAL AND SYNTHESIS

METHODS

We assessed the quality of the included studies using the AHRQ and NOS assessment, but the heterogeneity of the studies did not allow for data synthesis and meta-analyses.

RESULT: Hypercalciuria, hypocitraturia, and hyperoxaluria are the most prevalent in pediatric nephrolithiasis. Obese pediatric patients would have different urinary mineral profiles depending on the region, dietary habits, and heritability. Also, we found that children of different ages may have varying risk factors for stones. Increasing fluid intake is a simple and affordable strategy for preventing kidney stones, as recommended for children. Improving poor nutritional habits would aid in the decrease of metabolic variables involved in stone formation.

CONCLUSIONS AND IMPLICATIONS OF KEY FINDINGS: Obesity alone may not contribute to stone formation in pediatrics, but a combination of metabolic factors, different urinary mineral profiles, and abnormal metabolic status may predispose to stones in children, owing to children tending to undergo rapid changes in growth in a relatively short period, and partly due to different risk factors for stones in different regions. In addition to BMI, other indicators such as %BF (percent body fat) and BRI (body roundness index) may be used to comprehensively assess nutritional status and metabolism in children. Evaluating individual metabolic profiles and promoting increased fluid intake are simple, cost-effective strategies for preventing kidney stones in this population.

SYSTEMATIC REVIEW REGISTRATION NUMBER: CRD4202456817.