Global, regional and national burden of paediatric urinary stone disease from 1990 to 2021: a systematic analysis for the Global Burden of Disease Study 2021.

OBJECTIVES: Paediatric urinary stone disease (PUSD) is a prevalent urological issue affecting children worldwide. Its incidence varies based on region and socioeconomic factors. Recognising trends in PUSD is vital for developing effective policies to manage and prevent it. DESIGN: This study is a retrospective, observational and population-based analysis using data from the Global Burden of Disease (GBD) Study 2021. The research systematically assessed the incidence, mortality and disability-adjusted life-years (DALYs) of PUSD from 1990 to 2021 across global, regional and national levels. Temporal trends were analysed by calculating the average annual percentage change using the joinpoint regression model, while the estimated annual percentage Changes (EAPCs) were obtained from linear regression models on PUSD rates. SETTING: This study used publicly available data from the GBD Study 2021 and did not involve specific healthcare facilities. PARTICIPANTS: Samples from the GBD database. INTERVENTIONS: Not applicable. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary measures were the incidence, mortality and DALYs of PUSD from 1990 to 2021. Secondary outcome measures included temporal trends stratified by age, gender, regions, nations and sociodemographic index (SDI) categories. RESULTS: Worldwide, PUSD cases increased from 1 355 160 in 1990 to 1 562 095 in 2021, although the incidence rate remained relatively stable (EAPC: -0.18). Mortality decreased considerably, with deaths falling from 180 in 1990 to 76 in 2021, and an EAPC for the mortality rate of -2.82. DALYs decreased from 18 975 in 1990 to 10 773 in 2021 (EAPC: -2.22). The burden varied across SDI regions, with low SDI regions showing rising incidence and high SDI regions experiencing declines. By sex, males consistently showed higher incidence, mortality and DALY rates than females from 1990 to 2021. However, both decreased over time, with the rate of decline in males slowing after the mid-2000s, leading to a persistent male excess in 2021. Geographically, East Asia showed the most significant reductions in mortality and DALYs, while South Asia and Western Sub-Saharan Africa showed increasing trends. Nationally, countries such as China and Georgia experienced substantial declines in incidence, mortality and DALYs, whereas Spain and Ecuador exhibited rising incidence rates. CONCLUSIONS: Although the global burden of PUSD has decreased in mortality and DALYs, the rising incidence in low-SDI regions emphasises the importance of equitable healthcare policies and better preventative measures.