The Impact of Body Mass Index on Quantitative 24-h Urine Chemistries in Pediatric Urolithiasis: A Systematic Review and Meta-Analysis
Urology Journal,
Vol. 23 No. 02 (2026),
20 June 2026
,
Page 37-47
https://doi.org/10.22037/uj.v23i00.8445
Abstract
Purpose: To study the effect of body mass index (BMI) on 24-h urine quantitative analysis in pediatric urolithiasis, and to explore whether obesity and overweight promote the formation of urinary calculi in children.
Materials and Methods: A comprehensive search of EMBASE, PubMed, the Cochrane Library, Web of Science, and Scopus was conducted in March 2024 and updated in October 2025 to identify all related studies. BMI was used to specify body size. Predetermined inclusion and exclusion criteria were used to screen each article. Data from appropriate studies were extracted, and a meta-analysis was performed using Stata 14.0 software.
Results: Eight studies, including 1033 children with urolithiasis who underwent 24-h urine collection for chemical analysis, were included in this meta-analysis. The BMI ≥ 85th percentile group exhibited significantly higher uric acid excretion (SMD = 0.756, 95% CI = 0.092–1.420, P = .026). No statistically significant differences were found in calcium (SMD = -0.320, 95% CI = -0.600 to -0.050, P = .519), 24-h urine volume (SMD = -0.310, 95% CI = -0.790 to 0.160, P = .555), magnesium (SMD = -0.470, 95% CI = -0.820 to -0.120, P = .471), phosphate (SMD = -0.360, 95% CI = -0.610 to -0.110, P = .805), oxalate (SMD = -0.110, 95% CI = -0.390 to 0.170, P = .315), citrate (SMD = -0.190, 95% CI = -0.680 to 0.290, P = .057), or sodium (SMD = 0.200, 95% CI = -0.390 to 0.800, P = .050) excretion between the two groups. Sensitivity analyses confirmed the robustness of these findings.
Conclusion: While overweight/obese children with urolithiasis demonstrate higher urinary uric acid excretion, the absence of significant differences in other key urinary risk factors suggests that BMI alone should not be considered a separate and definitive risk factor for pediatric urolithiasis.
- pediatric urolithiasis
- body mass index
- pediatric obesity
- 24-h urine analysis
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References
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