Pediatric Kidney Stones Research

Pediatric Kidney Stones Research | CPCE

The incidence of pediatric kidney stones (nephrolithiasis) has increased dramatically over the last 25 years for reasons that are not well-described. This has resulted in uncertainty of how to best evaluate children with suspected kidney stones and how to effectively decrease recurrence for patients whose first stone developed during childhood. This line of CPCE research, led by Gregory Tasian, MD, MSc, MSCE, seeks to address these knowledge gaps.

Temporal Trends of Adult and Pediatric Kidney Stone Incidence

Temperature and Kidney Stone Risk

Mobile Device Hydration Reminders for Adolescents With Kidney Stones

Pediatric Kidney Stone Published Research


Temporal Trends of Adult and Pediatric Kidney Stone Incidence

This study seeks to define the annual incidence of kidney stones among children and adults over a 16-year time period in South Carolina. Using a serial cross-sectional design and generalized linear models, we are estimating the incidence rates of nephrolithiasis and determining how these rates differ by age, sex, and race. The preliminary results suggest the incidence has increased the most among adolescents, particularly females, and among African-Americans, which are a reversal of historical trends.

Funding:  National Institutes of Health

Please contact Gregory Tasian, MD, MSc, MSCE, attending urologist at CHOP, for more information about this line of research.


Temperature and Kidney Stone Risk

This study seeks to define the association between the temperature of a person’s environment and the risk of presenting with kidney stones. Using a case-crossover design and distributed lag nonlinear models, we are estimating the relative risk of kidney stone presentation associated with the daily temperatures on patients who sought treatment for kidney stones in the cities of Atlanta, Chicago, Dallas, Los Angeles, and Philadelphia. The results demonstrated that high and low mean daily environmental temperatures increased the relative risk of kidney stone presentation in most cities.

Click here to read more about this area of research on The Children's Hospital of Philadelphia’s website.

See the Published Research

Funding:  National Institutes of Health

Please contact Gregory Tasian, MD, MSc, MSCE, attending urologist at CHOP, for more information about this line of research.


Mobile Device Hydration Reminders for Adolescents With Kidney Stones

Although previously studied in adults, this prospective cohort study is the first to explore the barriers to water intake among adolescents with pediatric kidney stones, or nephrolithiasis. Young adults may exhibit different barriers than adults, and therefore require a different approach to prevention. For instance, youth differ from adults in their cognitive control and decision-making processes, as well as differences in their daily activities (e.g., school/summer vacation vs. work).

We are utilizing an approach called Ecological Momentary Assessment (EMA), where real-time data is gathered throughout the day in subjects’ normal environments through mobile devices. Through EMA, we will identify the setting characteristics associated with water intake, including time, temperature, place, activity, mindfulness of and attitudes towards water, and access to beverages.

The focus on real time momentary assessment—collecting data about what is going on right at the moment or over the very recent past—provides several distinct advantages over other methods such as focus groups:

  1. EMA overcomes recall bias for children as young as age seven because subjects are asked about what is happening at a particular moment in time
  2. EMA allows understanding of how events, behaviors, and experiences play out over time, context, and place. Drinking water is a discrete event that may be influenced by physiologic, psychological, and situational factors that change over the course of the day and year, so this is of particular importance.

Funding: National Institutes of Health

Please contact Gregory Tasian, MD, MSc, MSCE, attending urologist at CHOP, for more information about this line of research.

Click here to read more about health information technology (HIT) research at CPCE


Pediatric Kidney Stones Published Research

Effect of Temperature on Kidney Stone Risk
Tasian GE, Pulido JE, Gasparrini A, Saigal CS, Horton BP, Landis JR, Madison R, Keren R; Urologic Diseases in America Project. Daily Mean Temperature and Clinical Kidney Stone Presentation in Five U.S. Metropolitan Areas: A time-series analysis. Environ Health Perspect. 2014 Oct;122(10):81-7.

Other Published Research on Pediatric Kidney Stones
Denburg M, Jemielita T, Tasian GE, Haynes K, Mucksavage P, Shults J, Copelovitch L. Risk of Incident Hypertension and Chronic Kidney Disease Following Shock Wave Lithotripsy and Ureteroscopy: A Population-Based Cohort Study Using The Health Improvement Network. Kidney International. In press.

Denburg M, Leonard M, Haynes K, Tuchman S, Tasian GE, Shults J, Copelovitch L. Risk of Fracture in Urolithiasis: A Population-Based Cohort Study Using the Health Improvement Network. Clin J Am Soc Nephrol. 2014 Dec;9(12):2133-40.

Tasian GE, Cost NG, Granberg CF, Pulido JE, Rivera M, Schwen Z, Schulte M, Fox JA. Tamsulosin and the spontaneous passage of ureteral stones in children: A multi-institutional cohort study.  J Urol. 2014 Aug;192(2):506-11.

Tasian GE, Pulido JE, Keren R, Dick A, Setodji C, Hanley J, Madison R, Saigal CS. Use of and Regional Variation in Initial CT Imaging for Kidney Stones. Pediatrics. 2014 Nov;134(5):909-15.

Ziemba JB, Canning DA, Lavelle J, Kalmus A, Tasian GE. Patient and Institutional Characteristics Associated with Initial Computerized Tomography in Children Presenting to the Emergency Department with Kidney Stones. J Urol. 2015 May:193(5 Suppl): 1848-53.