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儿童肾结石疾病的流行病学见解

Epidemiologic insights into pediatric kidney stone disease.

作者信息

Matlaga Brian R, Schaeffer Anthony J, Novak Thomas E, Trock Bruce J

机构信息

James Buchanan Brady Urological Institute, The Johns Hopkins University School of Medicine, Park 2, 600 North Wolfe Street, Baltimore, MD 21287, USA.

出版信息

Urol Res. 2010 Dec;38(6):453-7. doi: 10.1007/s00240-010-0327-9. Epub 2010 Oct 22.

Abstract

The epidemiology of pediatric kidney stone has not yet been as rigorously defined as that of adult kidney stone disease. Herein, we review our recent epidemiologic works characterizing pediatric stone disease using the Kids' Inpatient Database (KID). Specifically we investigated the age and gender distribution of pediatric kidney stone disease, changes in disease prevalence over time, and medical comorbidities associated with this disorder. We identified patients by International Classification of Disease 9th Edition (ICD-9) codes for renal and ureteral calculi as the primary diagnosis. Medical comorbidities were identified using specific comorbidity software. Statistical comparisons between children with and without stone disease were performed. In the first decade of life, stone disease was more prevalent among males than females; however, in the second decade of life females were more commonly affected. Of note, there was a significant increase in treated stone disease across both genders between 1997 and 2003. We also found that the risk of kidney stone diagnosis in children younger than 6 years of age was significantly associated with hypertension and diabetes mellitus. The gender distribution among pediatric stone formers varies significantly by age, although overall females have a greater prevalence than males. There is also a strong association of stone disease and both diabetes and hypertension, although this was only observed in children less than 6 years of age. Taken all together, these findings suggest that urolithiasis in the young child is a complex systemic disease process.

摘要

儿童肾结石的流行病学尚未像成人肾结石疾病那样得到严格界定。在此,我们回顾了我们最近利用儿童住院数据库(KID)对儿童结石病进行特征描述的流行病学研究。具体而言,我们调查了儿童肾结石疾病的年龄和性别分布、疾病患病率随时间的变化以及与该疾病相关的医疗合并症。我们通过国际疾病分类第9版(ICD - 9)编码将肾和输尿管结石作为主要诊断来识别患者。使用特定的合并症软件识别医疗合并症。对有结石病和无结石病的儿童进行了统计学比较。在生命的第一个十年,结石病在男性中比女性更普遍;然而,在第二个十年,女性更常受到影响。值得注意的是,在1997年至2003年期间,两性中接受治疗的结石病都有显著增加。我们还发现,6岁以下儿童被诊断为肾结石的风险与高血压和糖尿病显著相关。尽管总体上女性患病率高于男性,但儿童结石患者的性别分布随年龄有显著差异。结石病与糖尿病和高血压也有很强的关联,尽管这仅在6岁以下儿童中观察到。综上所述,这些发现表明幼儿尿路结石是一个复杂的全身性疾病过程。

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