1887
Volume 2025, Issue 3
  • ISSN: 1999-7086
  • EISSN: 1999-7094

Abstract

Urolithiasis in children is associated with high recurrence rates and complications, and its prevalence has been rising in recent decades due to metabolic and non-metabolic risk factors. This study aimed to evaluate the prevalence of pediatric urolithiasis in the Eastern Mediterranean Region (EMRO).

This systematic review was conducted using international databases, including Scopus, PubMed/MEDLINE, Web of Science, Embase, Google Scholar, and ProQuest, covering available data up to the end of August 2024. The Cochran test and I² statistics were applied to assess study heterogeneity. Additional analyses were performed using STATA software version 14.

A total of 1,365 studies were reviewed, and 24 studies met the inclusion criteria. The overall prevalence of urinary stones in children was 2.34% (95% CI, 1.93–2.75). The highest prevalence rates were reported in Somalia (12.8% from one study), Pakistan (11.71% from four studies), and Turkey (9.28% from two studies). In contrast, the lowest prevalence rates were observed in Saudi Arabia (1.09% from one study), Egypt (3.48% from two studies), and Iran (4.45% from eight studies). Additionally, a non-significant decrease in the prevalence of urolithiasis was observed with increasing Human Development Index (HDI; Reg Coef = −2.60 [95% CI, −7.49 to 2.29]).

This study highlights the relatively low prevalence of urinary stones in children across EMRO countries. Furthermore, factors such as income levels and HDI were shown to be relevant, providing valuable insights for both regional and global health authorities in improving the management, screening, and treatment of pediatric urolithiasis.

© 2025 Al-Naggar, Aljuma’ai, Ahmed, Alnadhari, Al-Hagri, Alhakamy, et al., licensee HBKU Press..
Loading

Article metrics loading...

/content/journals/10.5339/jemtac.2025.40
2025-09-16
2025-12-05

Metrics

Loading full text...

Full text loading...

/deliver/fulltext/jemtac/2025/3/jemtac.2025.40.html?itemId=/content/journals/10.5339/jemtac.2025.40&mimeType=html&fmt=ahah

References

  1. Shoag J, Halpern J, Goldfarb DS, Eisner BH. Risk of chronic and end stage kidney disease in patients with nephrolithiasis. J Urol. 2014 Nov; 192:(5):1440–5.https://doi.org/10.1016/j.juro.2014.05.117
     [Google Scholar]
  2. Mohsen WM, Alabdulqader DK, Ezzat MA, Nahedh ZAK, Mukhlef HAY, Alshami MAS, et al. Prevalence and pathophysiology of pediatric urolithiasis - a review. J Pharm Res Int. 2021; 33:(45A):236–42. https://doi.org/10.9734/jpri/2021/v33i45A32738
     [Google Scholar]
  3. Tasian GE, Kabarriti AE, Kalmus A, Furth SL. Kidney stone recurrence among children and adolescents. J Urol. 2017 Jan; 197:(1):246–52.https://doi.org/10.1016/j.juro.2016.07.090
     [Google Scholar]
  4. Wang H-HS, Wiener JS, Lipkin ME, Charles D Scales J, Ross SS, et al. Estimating the nationwide, hospital based economic impact of pediatric urolithiasis. J Urol. 2015 May; 193:(5 Suppl):1855-9. https://doi.org/10.1016/j.juro.2014.09.116
     [Google Scholar]
  5. VanDervoort K, Wiesen J, Frank R, Vento S, Crosby V, Chandra M, et al. Urolithiasis in pediatric patients: a single center study of incidence, clinical presentation and outcome. J Urol. 2007 Jun; 177:(6):2300–5.https://doi.org/10.1016/j.juro.2007.02.002
     [Google Scholar]
  6. Ward JB, Feinstein L, Pierce C, Lim J, Abbott KC, Bavendam T, et al. Pediatric urinary stone disease in the United States: the urologic diseases in America Project. Urology. 2019 Jul; 129:180.https://doi.org/10.1016/j.urology.2019.04.012
     [Google Scholar]
  7. Zakaria M, Azab S, Rafaat M. Assessment of risk factors of pediatric urolithiasis in Egypt. Transl Androl Urol. 2012 Dec; 1:(4):209-15.https://doi.org/10.3978/j.issn.2223-4683.2012.09.03
     [Google Scholar]
  8. Lasorsa F, Caliolo C, Silecchia A, Laricchiuta N, Raguso M, Ditonno P, et al. Management of pediatric urolithiasis in an Italian Tertiary Referral Center: a retrospective analysis. Medicina (Kaunas). 2023 Dec; 59:(12):2165.https://doi.org/10.3390/medicina59122165
     [Google Scholar]
  9. Miah T, Kamat D. Pediatric nephrolithiasis: a review. Pediatr Ann. 2017 Jun; 46:(6):e242–e4.https://doi.org/10.3928/19382359-20170517-02
     [Google Scholar]
  10. López M, Hoppe B. History, epidemiology and regional diversities of urolithiasis. Pediatr Nephrol. 2010 Jan; 25:(1):49–59.https://doi.org/10.1007/s00467-008-0960-5
     [Google Scholar]
  11. López M, Hoppe B. History, epidemiology and regional diversities of urolithiasis. Pediatr Nephrol. 2010 Jan; 25:(1):49–59.https://doi.org/10.1007/s00467-008-0960-5
     [Google Scholar]
  12. Geraghty RM, Proietti S, Traxer O, Archer M, Somani BK. Worldwide impact of warmer seasons on the incidence of renal colic and kidney stone disease: evidence from a systematic review of literature. J Endourol. 2017 Aug; 31:(8):729–35.https://doi.org/10.1089/end.2017.0123
     [Google Scholar]
  13. World Health Organization - EMRO. About us. https://www.emro.who.int/entity/about-us/index.html#:~:text=It%20serves%20the%20WHO%20Eastern,of%20nearly%20745%20million%20people
     [Google Scholar]
  14. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. Updating guidance for reporting systematic reviews: development of the PRISMA 2020 statement. J Clin Epidemiol. 2021 Jun; 134:103.https://doi.org/10.1016/j.jclinepi.2021.02.003
     [Google Scholar]
  15. Wikipedia. Child. https://en.wikipedia.org/wiki/Child[Accessed September 2024].
     [Google Scholar]
  16. Otoukesh S, Mojtahedzadeh M, Cooper CJ, Tolouian R, Said S, Ortega L, et al. Lessons from the profile of kidney diseases among Afghan refugees. Med Sci Monit. 2014 Sep; 20:1621.https://doi.org/10.12659/MSM.890958
     [Google Scholar]
  17. Hollander AC, Dal H, Lewis G, Magnusson C, Kirkbride JB, Dalman C. Refugee migration and risk of schizophrenia and other non-affective psychoses: cohort study of 1.3 million people in Sweden. BMJ. 2016 Mar; 352:i1030.https://doi.org/10.1136/bmj.i1030
     [Google Scholar]
  18. Meisinger C, Döring A, Löwel H; KORA Study Group. Chronic kidney disease and risk of incident myocardial infarction and all-cause and cardiovascular disease mortality in middle-aged men and women from the general population. Eur Heart J. 2006 May; 27:(10):1245–50.https://doi.org/10.1093/eurheartj/ehi880
     [Google Scholar]
  19. The World Bank. World Bank Country and Lending Groups - database. https://datahelpdesk.worldbank.org/knowledgebase/articles/906519-world-bank-country-and-lending-groups?_gl=1*7rjy0c*_gcl_au*NTkyMDcxMTI5LjE3MjcwNzY5NDI[Accessed September 2024].
     [Google Scholar]
  20. Human Development Reports. Program UND. Human Development Index (HDI)https://hdr.undp.org/data-center/human-development-index#/indicies/HDI[Accessed September 2024].
     [Google Scholar]
  21. Peterson J, Welch V, Losos M, Tugwell P. The Newcastle-Ottawa Scale (NOS) for Assessing the Quality of Nonrandomised Studies in Meta-analyses. Ottawa: Ottawa Hospital Research Institute; 2011.
     [Google Scholar]
  22. Begg CB, Berlin JA. Publication bias and dissemination of clinical research. J Natl Cancer Inst. 1989 Jan; 81:(2):107–15.https://doi.org/10.1093/jnci/81.2.107
     [Google Scholar]
  23. Abboud IA. Prevalence of urolithiasis in adults due to environmental influences: a case study from northern and central Jordan. Jordan J Earth Environ Sci. 2018 Jan; 9:(1):29–38.
     [Google Scholar]
  24. Abdelraheem M, Ali E, Osman R, Ellidir R, Bushara A, Hussein R, et al. Outcome of acute kidney injury in sudanese children – an experience from a sub-Saharan African unit. Perit Dial Int. 2014 Jul– Aug;34:(5):526–33.https://doi.org/10.3747/pdi.2013.00082
     [Google Scholar]
  25. Abdinia B, Mohkam M, Karimi A, Alikhah F. Prevalence rate of urinary tract infection and disorder of urinary profiles in the 7-12 years old healthy children in Tabriz, Iran. Arch Pediat Infect Dis. 2013 Oct; 1:(3):122–5.https://doi.org/10.5812/pedinfect.10347
     [Google Scholar]
  26. Abdelhalim RE, Alhadramy MS, Hussein M, Baghlaf AO, Alsibaai AA, Noorwali AW, et al. The prevalence of urolithiasis in the Western region of Saudi-Arabia: a population survey. Urol Res. 1988; 16:(3):203.
     [Google Scholar]
  27. Akbalik Kara M, Demircioglu Kilic B, Col N, Ozcelik AA, Buyukcelik M, Balat A. Kidney disease profile of Syrian refugee children. Iran J Kidney Dis. 2017 Mar; 11:(2):109–14.
    [Google Scholar]
  28. Akhavan-Sepahi M, Sharifian M, Mohkam M, Vafadar M, Hejazi S. Biochemical risk factors for stone formation in healthy school children. Acta Med Iran. 2012; 50:(12):814–8.
     [Google Scholar]
  29. Akl K, Ghawanmeh R. The clinical spectrum of idiopathic hyperuricosuria in children: isolated and associated with hypercalciuria/hyperoxaluria. Saudi J Kidney Dis Transpl. 2012 Sep; 23:(5):979–84.https://doi.org/10.4103/1319-2442.100879
     [Google Scholar]
  30. Al Riyami MS, Al Ghaithi B, Al Hashmi N, Al Kalbani N. Primary hyperoxaluria type 1 in 18 children: genotyping and outcome. Int J Nephrol. 2015; 2015:634175. https://doi.org/10.1155/2015/634175
     [Google Scholar]
  31. Bakr A, Sarhan A, Hammad A, Ragab M, Salama OS, Al-Husseni F, et al. Asymptomatic urinary abnormalities among primary school children in Egypt. World J Pediatr. 2007 Aug; 3:(3):214–7.
    [Google Scholar]
  32. Balat A, Kilic BD, Aksu B, Kara MA, Buyukcelik M, Agbas A, et al. Kidney disease profile and encountered problems during follow-up in Syrian refugee children: a multicenter retrospective study. Pediatr Nephrol. 2022 Feb; 37:(2):393–402.https://doi.org/10.1007/s00467-021-05046-3
     [Google Scholar]
  33. Basiri A, Kashi AH, Salehi Omran H, Borumandnia N, Golshan S, Narouie B, et al. National Lifetime Prevalence and Demographic Factors of Urolithiasis in Iran. Urol J. 2023 Feb; 20:(2):102–8.https://doi.org/10.22037/uj.v20i.7576
     [Google Scholar]
  34. Dirie NI, Adam MH, Garba B, Dahie HA, Sh. Nur MA, Mohamed FY, et al. The prevalence of urolithiasis in subjects undergoing computer tomography in selected referral diagnostic centers in Mogadishu, Somalia. Front Public Health. 2023 Oct; 11:1203640.https://doi.org/10.3389/fpubh.2023.1203640
     [Google Scholar]
  35. Ejaz I, Khan HI. Pattern of renal diseases in children: our experience from a tertiary care hospital of Lahore. Pak Paediatr J. 2009; 33:(4):233–7.
     [Google Scholar]
  36. Fahimi D, Khedmat L, Afshin A, Noparast Z, Jafaripor M, Beigi EH, et al. Clinical manifestations, laboratory markers, and renal ultrasonographic examinations in 1-month to 12-year-old Iranian children with pyelonephritis: a six-year cross-sectional retrospective study. BMC Infect Dis. 2021 Feb; 21:(1):189.https://doi.org/10.1186/s12879-021-05887-1
     [Google Scholar]
  37. Fallahzadeh MK, Fallahzadeh MH, Mowla A, Derakhshan A. Hypercalciuria in children with urinary tract symptoms. Saudi J Kidney Dis Transpl. 2010 Jul; 21:(4):673–7.
    [Google Scholar]
  38. Fallahzadeh MK, Fallahzadeh MH, Derakhshan A, Basiratnia M, Al-Hashemi GH, Fallahzadeh MA, et al. Urinary tract infection after kidney transplantation in children and adolescents. Iran J Kidney Dis. 2011 Nov; 5:(6):416–9.
     [Google Scholar]
  39. Jamro S, Channa NA, Shaikh AH, Ramzan A. Chronic renal failure in children. J Pak Med Assoc. 2003 Apr; 53:(4):140–2.
     [Google Scholar]
  40. Kari JA, El Desoky SM, Farag YM, Singh AK. Predictors of renal replacement therapy and mortality in children with chronic kidney disease. Saudi Med J. 2015 Jan; 36:(1):32–9.https://doi.org/10.15537/smj.2015.1.9774
     [Google Scholar]
  41. Madani A, Kermani N, Ataei N, Esfahani ST, Hajizadeh N, Khazaeipour Z, et al. Urinary calcium and uric acid excretion in children with vesicoureteral reflux. Pediatr Nephrol. 2012 Jan; 27:(1):95–9.https://doi.org/10.1007/s00467-011-1936-4
     [Google Scholar]
  42. Omar AM, Kamal NN, Abdelmgeed AS, Abdelrehim MG. Epidemiology of urinary stones in children Attending Minia University Hospital for Urology. Minia J Med Res. 2024 Jan; 35:(1):16–23.https://doi.org/10.21608/mjmr.2024.257978.1577
     [Google Scholar]
  43. Rahman AJ, Hanif S, Baloch NUA, Rehman A, Sheikh T, Ladhani MI. Spectrum, management and outcomes of structural and functional uropathies in children attending a tertiary care center in Karachi; Pakistan. J Pak Med Assoc. 2018; Nov68:(11):1699–703.
     [Google Scholar]
  44. Rizvi SA, Naqvi SA, Hussain Z, Hashmi A, Akhtar F, Zafar MN, et al. Living-related pediatric renal transplants: a single-center experience from a developing country. Pediatr Transplant. 2002 Apr; 6:(2):101–10.https://doi.org/10.1034/j.1399-3046.2002.01039.x
     [Google Scholar]
  45. Sannathimmappa MB, Gouda P, Al-Mohana MHJ, Alisaii GKH, Al-Jahwari RJM, Al Maqbali RKA, et al. Risk factors, bacterial profile, and outcomes of urinary tract infection among children treated at a secondary care hospital in Oman. J Krishna Inst Med Sci. 2024 Apr-Jun; 13:(2):67–77.
     [Google Scholar]
  46. Tresa V, Yaseen A, Lanewala AA, Hashmi S, Khatri S, Ali I, et al. Etiology, clinical profile and short-term outcome of acute kidney injury in children at a tertiary care pediatric nephrology center in Pakistan. Ren Fail. 2017 Nov; 39:(1):26–31.https://doi.org/10.1080/0886022X.2016.1244074
     [Google Scholar]
  47. Mai Z, Liu Y, Wu W, Aierken A, Jiang C, Batur J, et al. Prevalence of urolithiasis among the Uyghur children of China: a population-based cross-sectional study. BJU Int. 2019 Sep; 124:(3):395–400.https://doi.org/10.1111/bju.14776
     [Google Scholar]
  48. Remzi D, Cakmak F, Erkan I. A study on the urolithiasis incidence in Turkish school-age children. J Urol. 1980 Apr; 123:(4):608.https://doi.org/10.1016/s0022-5347(17)56063-2
     [Google Scholar]
  49. Sorokin I, Mamoulakis C, Miyazawa K, Rodgers A, Talati J, Lotan Y. Epidemiology of stone disease across the world. World J Urol. 2017 Sep; 35:(9):1301–20.https://doi.org/10.1007/s00345-017-2008-6
     [Google Scholar]
  50. MK G, MY S. Results of medical treatment and metabolic risk factors in children with urolithiasis. Pediatr Nephrol. 2011 Jun; 26:(6):933–7.https://doi.org/10.1007/s00467-011-1803-3
     [Google Scholar]
  51. Yousefichaijan P, Safi F, Rezagholizamenjany M, Safari M, Shariatmadari F. Prevalence of vesicoureteral reflux and urinary tract infection in children with and without urolithiasis. Nephro-Urol Month. 2020 Nov; 12:(4):e103276.https://doi.org/10.5812/numonthly.103276
     [Google Scholar]
  52. Starcea IM, Miron I, Lupu A, Ioniuc I, Alecsa M, Azoicai A, et al. Unraveling chronic kidney disease in children: a surprising manifestation of celiac disease. Front Pediatr. 2024 Apr; 12:1384591.https://doi.org/10.3389/fped.2024.1384591
     [Google Scholar]
/content/journals/10.5339/jemtac.2025.40
Loading
Prevalence of urolithiasis in children from the EMRO region: A systematic review and meta-analysis
Journal of Emergency Medicine, Trauma and Acute Care 2025, 40 (2025); https://doi.org/10.5339/jemtac.2025.40
/content/journals/10.5339/jemtac.2025.40
/content/journals/10.5339/jemtac.2025.40
Loading

Data & Media loading...

  • Article Type: Review Article
Keyword(s): calculi, Children, nephrolithiasis, pediatric, prevalence and urolithiasis

Most Cited Most Cited RSS feed

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error