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. 2025 Apr 11;184(5):290.
doi: 10.1007/s00431-025-06134-4.

Global burden of pediatric urolithiasis: A trend and health inequalities analysis from 1990 to 2021

Zheng Xu  1 , Tianfu Ding  1 , Daxun Luo  1 , Yang Chen  1 , Yubao Liu  1 , Haifeng Song  1 , Boxing Su  1 , Bo Xiao  2 , Jianxing Li  3
Affiliations

Global burden of pediatric urolithiasis: A trend and health inequalities analysis from 1990 to 2021

Zheng Xu et al. Eur J Pediatr. .

Abstract

This research seeks to evaluate the worldwide burden, health inequities, and projected trends of pediatric urolithiasis from 1990 through 2021. We calculated age-standardized incidence rates, prevalence rates, and disability-adjusted life years rates from the 2021 Global Burden of Disease database. Joinpoint regression was applied for time-trend analysis. Health disparities were measured by using Spearman correlation analysis, Relative Concentration Index, and Slope Index of Inequality. Bayesian Age-Period-Cohort models predicted future global age-standardized incidence rates trends. Global age-standardized incidence rates declined from 79 (95% confidence interval [CI], 38-132) cases per 100,000 population in 1990 to 75 (95% CI, 37-124) cases per 100,000 in 2021, although the total number of cases rose. Age-standardized incidence rates decrease sharper in high Socio-Demographic Index regions. Geographical differences reveal significant health disparities, with age-standardized disability-adjusted life years rates higher in countries with a low Socio-Demographic Index. Bayesian Age-Period-Cohort models forecast a slight rise in global age-standardized incidence rates.

Conclusions: While global age-standardized incidence rates for pediatric urolithiasis have shown a downward trend, the increasing number of cases and persistent age-standardized disability-adjusted life years rates burden in low-SDI regions underscore pressing concerns. Efforts focused on prevention, early detection, and equitable access to healthcare are critical to bridging these gaps and improving global outcomes.

What is known: • Pediatric urolithiasis imposes a significant global burden, with higher recurrence rates and long-term impacts on kidney function. • The incidence of urolithiasis in children varies greatly in different countries or regions around the world.

What is new: • This study provides the comprehensive analysis of global trends and health inequalities in pediatric urolithiasis from 1990 to 2021 using GBD 2021 data. • Persistent inequalities remain, with disadvantaged regions bearing heavier burdens despite global improvements.

Keywords: Age-standardized rate; Disability adjusted life-years; Global burden of disease; Incidence; Prevalence; Urolithiasis.

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Conflict of interest statement

Declarations. Ethics approval: This study did not involve patient personal information. The data usage complies with the Institute for Health Metrics and Evaluation (“IHME”) Free-of-Charge Non-commercial User Agreement, and no additional ethical approval was required. Consent to participate: Not applicable. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Trends in age-standardized incidence rates (A) and age-standardized disability-adjusted life years rates (B) in global and five SDI regions from 1990 to 2021. Abbreviations: DALYs, disability-adjusted life years; SDI, socio-demographic index; APC, annual percent change. *Indicates that the annual percent change is significantly different from zero at the alpha = 0.05 level
Fig. 2
Fig. 2
The age-standardized incidence rates (A) and disability-adjusted life years rates (C) of pediatric urolithiasis in 2021. The average annual percent change of age-standardized incidence rates (B) and disability-adjusted life years rates (D) from 1990 to 2021. Enlarged versions of Panels A–D are provided in supplementary Sect. 7 for improved clarity
Fig. 3
Fig. 3
(A) Slope index of inequality (SII) for disability-adjusted life years by SDI Rank in 1990 and 2021. (B) Relative concentration index (RCI) of disability-adjusted life years by cumulative population rank in 1990 and 2021
Fig. 4
Fig. 4
The global trends in the age-standardized incidence rate of pediatric urolithiasis from 1990 to 2021, with projected trends from 2022 to 2045
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