Nationwide cohort analysis of pediatric urolithiasis: long-term metabolic, renal, and cardiovascular outcomes

Nationwide cohort analysis of pediatric urolithiasis: long-term metabolic, renal, and cardiovascular outcomes | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Nationwide cohort analysis of pediatric urolithiasis: long-term metabolic, renal, and cardiovascular outcomes Hsiao-hui Yang, Wan-Ting Huang, Jen-Hung Wang, Je-Wen Liou, Hao-Jen Hsu, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8075378/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 09 Mar, 2026 Read the published version in Pediatric Nephrology → Version 1 posted 5 You are reading this latest preprint version Abstract Background Pediatric urolithiasis is increasingly recognized not merely as a localized urinary disorder but as part of a systemic metabolic–inflammatory process that may predispose to chronic kidney and cardiovascular disease. However, population-based data in Asian pediatric populations with urolithiasis remain limited. This nationwide study investigated the epidemiologic trends, metabolic risk factors, and systemic outcomes associated with pediatric urolithiasis in Taiwan. Methods Using the National Health Insurance Research Database, children newly diagnosed with urolithiasis between January 2009 and December 2018 were identified and matched with controls according to age, sex, and index year. Comorbidities and medication exposures were evaluated, and outcomes including renal, cardiovascular, and metabolic complications were analyzed using Cox proportional hazards models. Results Among 10,113 affected children and 101,130 matched controls, the annual incidence of pediatric urolithiasis declined from 23.9 to 16.2 per 100,000 persons. A male predominance and peak incidence during adolescence were noted. Major associated factors included hypercalciuria (adjusted hazard ratio [aHR] 31.5), congenital urinary anomalies (aHR 22.6), urinary tract infection (aHR 8.3), and exposure to diuretics or antibiotics. Compared with controls, children with urolithiasis had significantly higher risks of chronic kidney disease (aHR 5.9), hypertension (aHR 1.9), ischemic heart disease (aHR 1.9), and dyslipidemia (aHR 1.8). Conclusions Despite a modest decline in incidence, pediatric urolithiasis remains a clinically important condition associated with long-term renal and cardiovascular morbidity. These findings highlight the importance of early metabolic evaluation, careful medication stewardship, and continued nephrology follow-up to mitigate chronic sequelae. pediatric urolithiasis metabolic risk chronic kidney disease cardiovascular complications nationwide cohort Figures Figure 1 Figure 2 Introduction Pediatric urolithiasis, which was previously considered a localized urinary disorder, is now increasingly recognized as part of a systemic process characterized by metabolic dysregulation and chronic low-grade inflammation [ 1 , 2 ]. Recent adult studies have shown associations between stone disease, hypertension, dyslipidemia, insulin resistance, and endothelial dysfunction, indicating shared pathogenic pathways between nephrolithiasis and cardiovascular–renal injury [ 1 , 3 , 4 ]. However, such systemic associations remain underexplored in children, in whom early metabolic disturbances may have long-term consequences for renal and vascular health. Globally, the incidence of pediatric urolithiasis has increased, reflecting changes in dietary habits, sedentary behavior, and climate [ 5 ]. Metabolic disorders account for 33%–95% of cases. Meanwhile, anatomic malformations and infections contribute to 8%–32% and 2%–24%, respectively [ 5 ]. Despite advancements in metabolic screening and infection control, occult nephrolithiasis may still present with recurrent symptoms and abnormal urinary solutes even in the absence of imaging evidence [ 6 ]. Beyond morbidity and recurrence, stone disease has emerged as a systemic condition associated with renal and cardiovascular complications in both adults and adolescents [ 7 , 8 ]. Previous population-based studies from Taiwan reported a 0.038% incidence of pediatric urolithiasis in 2007, with a peak occurrence during adolescence and a declining trend in incidence and healthcare utilization over time. Moreover, male patients exhibited an increasing frequency of upper urinary tract stone visits and higher recurrence rates (6.12% at 1 year and 34.71% at 5 years) [ 9 , 10 ]. Nevertheless, comprehensive data on nationwide trends, predisposing factors, and long-term systemic outcomes in pediatric populations remain lacking. Using the National Health Insurance Research Database (NHIRD), which covers nearly the whole Taiwanese population, the current study aimed to investigate the epidemiology, metabolic and structural risk factors, and systemic complications—spanning renal, cardiovascular, and metabolic domains—of pediatric urolithiasis. Materials and Methods Study Design and Data Sources This population-based retrospective cohort study used data from the Taiwan NHIRD, which includes medical information on more than 23 million residents. Patient records from Jan. 2009 to Dec. 2018 were obtained via the Health and Welfare Data Science Center [11, 12]. Urolithiasis cases were identified using diagnostic codes from both the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM, 2009–2015) and Tenth Revision (ICD-10-CM, 2016 onward). Annual incidence rates were calculated using population data from the Ministry of the Interior’s Public Birth Registry. Ethical Approval and Study Population The current study was conducted in accordance with the Declaration of Helsinki and approved by the Institutional Review Board of Hualien Tzu Chi Hospital (IRB111-023-B, April 21, 2022). The need for informed consent was waived owing to the retrospective nature of the study. The pediatric urolithiasis cohort included patients with a primary diagnosis of urolithiasis (ICD-9-CM codes: 592, 594, 274.11, and 788.0; ICD-10-CM codes: N13.2, N20.0–N20.2, N21, and N23) who had at least one hospitalization or two outpatient visits. The date of the first diagnosis was defined as the index date [11]. Patients with invalid or missing data were excluded from the analysis. Children with pre-index predisposing factors were categorized into the disease- or medication-related groups. Medication exposure was assessed using the Anatomical Therapeutic Chemical (ATC) Classification System, focusing on prolonged use (>30 days) of potential causative drugs. Patients with pre-existing comorbidities were included in the baseline analyses but excluded from the assessment of complication outcomes. Controls were randomly selected from the remaining NHIRD population and matched at a ratio of 1:10 according to sex, age, and index year (2009–2019), using identical exclusion criteria. Assessment of Urolithiasis-Related Complications The complications associated with renal, cardiovascular, and metabolic systems in both the urolithiasis and control groups were evaluated [7, 8]. Eligible events were defined as at least one hospitalization or two outpatient visits for the corresponding ICD-9/ICD-10 diagnoses occurring ≥30 days after the index date. Supplementary Table S1 shows the diagnostic, drug, and surgical codes used in this study. Evaluation of Treatment Modalities The treatment strategies, including surgical and pharmacologic interventions, were identified using the ICD-9/ICD-10 procedure codes and ATC drug classifications. The surgical procedures included endoscopic cystolitholapaxy (78024C, 78026C, and 78027C), ureteroscopy with stone removal (77026B, 77027B, and 77028B), ureterolithotomy (77001B, 77002B, and 77030B), percutaneous nephrostolithotomy (76016B, 76017B), and cystolithotomy (78005B) [13]. The pharmacologic treatments were identified using ATC codes for agents commonly prescribed for urolithiasis [14, 15]: Diuretics: thiazides (C03A) Alpha-adrenergic blockers: G04CA01–G04CA04 Smooth muscle relaxants: hyoscine butylbromide (Buscopan, A03BB01) and Rowapraxin (G04BD) Uric acid-lowering agents: allopurinol (M04AA012), benzbromarone (M04AB03) Urinary alkalinizing agents: potassium citrate (A12BA02) Patients who had used these medications for >30 days prior to the index date were excluded to prevent confounding by previous treatment. Only patients who were newly prescribed with medications for >30 days after diagnosis were included in the analysis [11]. Statistical Analysis The annual incidence rates stratified by age and sex were calculated using population data from the Ministry of the Interior. Descriptive statistics were presented as counts and percentages. The incidence rates were compared using the chi-square test. Univariate and multivariate Cox proportional hazards models were used to estimate adjusted hazard ratios (aHRs) for complications. All analyses were conducted using SAS version 9.4 (SAS Institute Inc., Cary, NC, the USA). A two-tailed P value of <0.05 was considered statistically significant. Results Demographic Characteristics of the Participants From 2008 to 2019, 11,576 pediatric patients were diagnosed with urolithiasis in Taiwan (Figure 1). After excluding patients diagnosed before 2009 (n = 1,416), 10,113 patients who were newly diagnosed between 2009 and 2018 and 101,130 age- and sex-matched controls were included in the analysis. The participants were followed-up until event occurrence, death, or December 31, 2019. The annual incidence of pediatric urolithiasis declined from 23.85 to 16.22 per 100,000 persons, yielding an overall cumulative rate of 20.25 per 100,000 (Figure 2). The mean age at diagnosis was 14.4 ± 4.4 years, and the male-to-female ratio was 1.5:1. As shown in Table 1 , patients with urolithiasis had a higher exposure to several medications than controls. The most evident standardized mean differences were observed for diuretics (thiazides: 0.108, furosemide: 0.239), antimicrobials (ceftriaxone: 0.115, trimethoprim–sulfamethoxazole: 0.268, aminoglycosides: 0.273, and quinolones: 0.259), and other drugs (glucocorticoids: 0.165, magnesium trisilicate: 0.448, and nonsteroidal anti-inflammatory drugs [NSAIDs]: 0.576). The standardized mean differences for the presence of disease-related factors such as urinary tract and cyst infections were also significantly high (0.379). The multivariate regression analysis ( Table 2 ) showed several independent risk factors. Among medication-related exposures, diuretics—including thiazides (aHR: 9.44), furosemide (aHR: 14.52), and combination of potassium-sparing agents (aHR: 14.26)—were strongly associated with urolithiasis. Patients who were taking antiepileptic drugs including topiramate (aHR: 2.86) and zonisamide (aHR: 3.68) were also at higher risks for urolithiasis. Antibiotics such as ceftriaxone (aHR: 2.42, P < 0.001), trimethoprim–sulfamethoxazole (aHR: 2.21, P < 0.001), aminoglycosides (aHR: 2.97, P < 0.001), and quinolones (aHR: 2.17, P < 0.001) were significantly associated with urolithiasis. The other contributors included glucocorticoids (aHR: 1.08), magnesium trisilicate (aHR: 1.63), and NSAIDs (aHR: 2.79). Disease-related factors such as hypercalciuria (aHR: 31.54), ureteropelvic junction obstruction (aHR: 19.88), congenital urinary tract anomalies (aHR: 22.58), and urinary tract infections (aHR: 8.28) had the strongest associations with urolithiasis. Complications Renal complications Children with urolithiasis were significantly at higher risks for renal complications compared with controls ( Table 3 ). Hematuria had the largest increase (724.6 vs. 34.8 per 100,000 person-years, IRR: 20.84, P < 0.001), followed by chronic kidney disease (13.5 vs. 2.0, IRR: 6.63, P < 0.001) and urinary tract/cyst infections (876.1 vs. 164.3, IRR: 5.33, P < 0.001). The other complications included enuresis (5.6 vs. 1.7, IRR: 3.31, P < 0.001) and proteinuria (68.4 vs. 31.1, IRR: 2.20, P < 0.001). The multivariate analyses confirmed significant aHRs for hematuria (17.76, 95% confidence interval [CI]: 15.28–20.65), chronic kidney disease (5.92, 95% CI: 3.08–11.35), urinary tract/cyst infections (4.57, 95% CI: 4.21–4.96), enuresis (3.16), and proteinuria (2.16). Cardiovascular complications Children with urolithiasis had significantly higher incidence rates of cardiovascular events. The most notable increases were for congestive heart failure (14.1 vs. 4.4, IRR: 3.21, P < 0.001), hypertension (61.3 vs. 24.0, IRR: 2.56, P < 0.001), ischemic stroke (4.9 vs. 2.0, IRR: 2.42, P < 0.001), and ischemic heart disease (8.0 vs. 3.4, IRR: 2.36, P < 0.001). The multivariate Cox models showed increased adjusted risks for congestive heart failure (aHR: 2.45, 95% CI: 1.49–4.04, P < 0.001), hypertension (aHR: 1.92, 95% CI: 1.11–4.90, P < 0.001), and ischemic heart disease (aHR: 1.93, 95% CI: 1.07–3.47, P = 0.03). Metabolic complications The cohort with urolithiasis presented with elevated incidence rates of metabolic syndrome (3.1 vs. 0.9 per 100,000 person-years) and dyslipidemia (95.9 vs. 48.9, P < 0.001). Adjusted analyses confirmed higher risks for metabolic syndrome (aHR: 4.15, 95% CI: 1.39–12.44, P = 0.01) and dyslipidemia (aHR: 1.83, 95% CI: 1.56–2.15, P < 0.001), as shown in Table 3. Treatment Patterns Among the 10,113 pediatric patients, 821 (8.1%) received surgical intervention. The majority of patients underwent ureteroscopy with stone removal (7.0%), followed by endoscopic cystolitholapaxy (0.9%), cystolithotomy (0.1%), and ureterolithotomy (0.08%). Approximately 30% of patients received pharmacologic therapy. Smooth muscle relaxants— hyoscine butylbromide (9.5%) and Rowapraxin (7.1%)—were most commonly prescribed, followed by urinary alkalinizing agents such as potassium citrate (6.5%) and alpha-adrenergic blockers. Preventive medications including thiazide diuretics and uric acid-lowering agents were not frequently used. The surgical and pharmacologic managements of pediatric urolithiasis were listed in Table 4 . Discussion This nationwide study provides the largest population-based assessment of pediatric urolithiasis in Taiwan. Although its incidence has declined modestly during the past decade, affected children exhibit substantially increased risks of renal, cardiovascular, and metabolic complications. These findings underscore that pediatric urolithiasis is not merely a transient urinary condition, but a systemic disorder with long-term health implications. Etiologic Heterogeneity and Metabolic Risk Unlike adult stone disease, which is often related to environmental and dietary factors, pediatric urolithiasis is primarily caused by metabolic disturbances, congenital anomalies, and infections [5, 16]. In our cohort, hypercalciuria was the most prominent risk factor, conferring a 31-fold higher risk of stone formation, which is consistent with previous studies identifying calcium handling defects as the main underlying mechanism [5, 6]. Dyslipidemia further increased the risk (aHR 2.2), suggesting that lipid dysregulation and oxidative stress contribute to tubular injury and crystal adhesion via the osteopontin-related pathways [8, 17, 18]. These findings support comprehensive metabolic screening even after the first episode of urolithiasis in children. Structural and Infectious Contributors Structural abnormalities such as ureteropelvic junction obstruction, vesicoureteral reflux, and cystic kidney disease further predispose to urinary stasis and infection [5]. In our analysis, congenital urinary anomalies and ureteropelvic junction obstruction increased the risk of stone formation by 22.6- and 19.9-fold, respectively. The coexistence of metabolic and structural abnormalities—as observed in up to 80% of affected children [5]—likely acts synergistically to enhance the risk of crystallization by combining urinary retention with altered solute composition. Urinary tract infection (UTI) remains another important contributor: urease-producing organisms elevate urinary pH and ammonium, promoting struvite stone formation [19]. Our data showed an 8.3-fold higher risk of urolithiasis in children with a previous UTI, consistent with earlier Taiwanese reports [20, 21]. Chronic infection and inflammation may also increase reactive oxygen species, accelerating crystal nucleation and tubular injury [22]. Furthermore, systemic conditions such as inflammatory bowel disease are associated with an increased stone risk (renal stone prevalence: 6.3%) [ 22 ], caused by bile salt and fat malabsorption that alters oxalate metabolism and by reduced urinary volume and citrate levels [23]. Disease severity, surgery, and antitumor necrosis factor therapy may further compound this risk. These findings underscore the multifactorial nature of pediatric urolithiasis, in which metabolic, structural, infectious, and systemic conditions interact to promote stone formation. Medication-Related Risks and Clinical Stewardship Medication exposure is another modifiable risk domain. Diuretics, antiepileptic agents, antibiotics, and NSAIDs were independently associated with the development of urolithiasis. Loop diuretics such as furosemide are associated with a 14.5-fold increased risk, likely due to calcium mobilization and hypercalciuria [24]. Thiazides—which are traditionally used to prevent recurrence—showed a paradoxical association with stone risk, possibly reflecting metabolic disturbances or confounding by indication [25]. Broad-spectrum antibiotics may alter gut microbiota, reducing Oxalobacter formigenes and enhancing oxalate absorption [5, 19]. NSAIDs, linked to renal papillary necrosis [26], increased 2.8-fold of urolithiasis risk. Further, carbonic anhydrase inhibitors (topiramate, zonisamide) and glucocorticoids modify urinary pH, calcium, and uric acid metabolism, thereby increasing crystal formation propensity [24]. These findings emphasize that even therapeutic exposures can alter the renal milieu toward lithogenesis and should be cautiously considered in clinical practice. Considering these multiple risk factors, management strategies must be individualized. Most neonatal nephrocalcinosis and small stones resolve spontaneously [21]. Stone size remains a key determinant of stone management. In particular, stones measuring 5 mm usually require intervention [15]. In our cohort, 8.12% of patients required surgery, and this value was comparable to that of a previous Taiwanese study (7.6%) [20]. Ureteroscopy was the most common procedure (86.85%), followed by endoscopic cystolitholapaxy (10.72%), cystolithotomy (1.46%), and ureterolithotomy (0.97%). Pharmacologic therapy is an important adjunct. Evidence on the use of medical expulsive therapy in children is limited [15]. However, agents such as Buscopan and Rowapraxin may relieve ureteral spasm, and tamsulosin facilitates the passage of small stones. Potassium citrate reduces recurrence by lowering urinary calcium levels and increasing pH, and uric acid-lowering agents combined with thiazides may further prevent stone formation [14]. In our cohort, the commonly used medications included Buscopan (9.49%), Rowapraxin (7.1%), potassium citrate (6.5%), and tamsulosin (3.75%). These findings emphasize the need for management strategies individualized based on stone size and metabolic profile, integrating pharmacologic therapy to prevent recurrence and improve outcomes. Systemic Outcomes and Clinical Significance Beyond local kidney injury, our findings revealed that pediatric urolithiasis carries important systemic consequences. Hematuria, which is observed in nearly 90% of cases, is caused by mechanical urothelial irritation and oxidative stress-induced microvascular fragility [15]. In our cohort, the incidence of hematuria was significantly elevated (IRR: 20.8, aHR: 17.8), and the condition frequently recurred, reflecting ongoing inflammatory stress. Proteinuria, a marker of glomerular hyperfiltration and tubular dysfunction, was twice as common in stone formers (aHR: 2.16), thereby supporting its role as an early indicator of progressive nephron injury [8]. Persistent proteinuria may further aggravate glomerulosclerosis and tubulointerstitial fibrosis, reinforcing the chronicity of kidney damage. UTI also displayed a bidirectional relationship with urolithiasis: stones promote bacterial adherence and obstruction. Meanwhile, infection facilitates struvite formation and inflammation [27]. Repeated infection maintains oxidative injury, thereby promoting a cycle of inflammation and fibrosis. Thus, chronic kidney disease emerges as a major long-term outcome; stone disease accounts for up to 8% of childhood kidney failure cases [28, 29]. In our cohort, the risk of chronic kidney disease was nearly 6-fold higher among stone formers. The mechanisms likely involve repeated obstruction, infection, and inflammatory insult, which reduce nephron number and renal reserve [30]. Interestingly, enuresis was more frequently observed in affected children (IRR: 3.31, aHR: 3.16), possibly reflecting impaired tubular water handling, reduced urine concentration ability, and autonomic dysregulation of bladder–sphincter coordination [31, 32]. The systemic nature of pediatric urolithiasis extends to cardiovascular and metabolic domains. Our study showed higher incidences of metabolic syndrome (IRR: 3.61, aHR: 4.15) and dyslipidemia (IRR: 1.96, aHR: 1.83) in affected children. This finding is similar to that of adult studies linking nephrolithiasis with insulin resistance and lipid metabolism disturbances [17]. Chronic inflammation and oxidative stress may represent the shared biological axis linking stone formation with endothelial dysfunction, reduced nitric oxide bioavailability, and vascular stiffness [33-35]. Inflammatory cytokines and activated macrophages, which are key mediators of atherosclerosis and cardiac remodeling [36, 37], may contribute to early vascular injury in this population. Consistent with adult data, our pediatric cohort exhibited two- to threefold higher risks of hypertension and ischemic heart disease [3, 8, 38]. Collectively, these findings support the concept that pediatric stone disease may be an early manifestation of systemic vascular vulnerability. The recognition of pediatric urolithiasis as a systemic metabolic–inflammatory disorder has several clinical implications. Routine follow-up of affected children should include not only imaging surveillance for recurrence but also laboratory assessment for proteinuria and dyslipidemia and blood pressure monitoring. Preventive strategies that aimed to reduce oxidative stress, improve endothelial function, and address modifiable metabolic risk factors—such as dietary habit, obesity, and physical inactivity—may attenuate long-term cardiovascular and renal complications [39]. Strengths and Limitations The strengths of this study include the inclusion of a large, nationally representative cohort and the implementation of a long-term follow-up, which allows for a robust assessment of both renal and systemic outcomes. Nonetheless, the current study had several limitations that should be acknowledged. The NHIRD lacks information on urinary biochemical parameters, stone composition, dietary habit, and imaging findings, precluding a detailed analysis of metabolic phenotypes and recurrence. Genetic predispositions and unmeasured lifestyle factors may also contribute to residual confounding. In conclusion, the incidence of pediatric urolithiasis in Taiwan has shown a gradual decline. However, the condition remains strongly associated with substantial renal, cardiovascular, and metabolic morbidity. These findings reinforce the emerging view that urolithiasis represents a systemic disorder driven by intertwined inflammatory and metabolic pathways. Early metabolic assessment and multidisciplinary preventive care are important for preserving long-term kidney function and mitigating cardiovascular risk in this vulnerable population. Declarations Funding: This work was supported by the Tzu Chi Medical Foundation, Taiwan (Grant number TCCF110195A). Competing interests: The authors have no relevant financial or non-financial interests to disclose. Ethics approval: The study was conducted in accordance with the Declaration of Helsinki and approved by the Institutional Review Board of Hualien Tzu Chi Hospital (IRB111-023-B, April 21, 2022). Consent: The need for informed consent was waived owing to the retrospective nature of the study. Data sharing statement: All data generated or analyzed during this study are included in this published article. Authors’ contribution: M. C. C., J. W. L., and H. J. H. conceived and designed the study. W. -T. H. and J. -H. W. prepared the materials and collected the data. H. -H. Y., W. -T. H., J. -H. W., and M. -C. C. analyzed and interpreted the patient data. H. -H. Y. and M. -C. C. wrote the first draft of the manuscript, and all authors commented on the previous versions of the manuscript. All the authors have read and approved the final version of the manuscript. Declaration of Generative AI and AI-assisted technologies in the writing process During the preparation of this work, the authors used ChatGPT (OpenAI) to assist in refining the English language and improving the clarity and logical flow of the manuscript. After using this tool, the author(s) thoroughly reviewed, revised, and verified all contents to ensure accuracy and originality, and take full responsibility for the final version of the manuscript. References Gambaro A, Lombardi G, Caletti C et al (2022) Nephrolithiasis: a red flag for cardiovascular risk. J Clin Med 11:5512. https://doi.org/10.3390/jcm11195512 Huang K, Peng Z, Zha C et al (2024) Inflammatory factors and the risk of urolithiasis: a bidirectional Mendelian randomization study. Front Med 11:1432275. https://doi.org/10.3389/fmed.2024.1432275 Peng JP, Zheng H (2017) Kidney stones may increase the risk of coronary heart disease and stroke: a PRISMA-compliant meta-analysis. 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J Am Coll Cardiol 67:1091–1103. https://doi.org/10.1016/j.jacc.2015.12.048 Adamo L, Rocha-Resende C, Prabhu SD, Mann DL (2020) Reappraising the role of inflammation in heart failure. Nat Rev Cardiol 17:269–285. https://doi.org/10.1038/s41569-019-0315-x Kim SY, Song CM, Bang W, Lim JS, Park B, Choi HG (2019) Nephrolithiasis predicts ischemic stroke: a longitudinal follow-up study using a national sample cohort. Int J Med Sci 16:1050–1056. https://doi.org/10.7150/ijms.34417 Wu YC, Hou CP, Weng SC (2023) Lifestyle and diet as risk factors for urinary stone formation: a study in a Taiwanese population. Medicina 59:1895. https://doi.org/10.3390/medicina59111895 Tables Table 1. Baseline demographic characteristics and medication- and disease-related risk factors of pediatric patients with and without urolithiasis Patients with urolithiasis Patients without urolithiasis SMD (n = 10113) (n = 101130) N % N % Age (mean, SD) 14.42 4.42 14.42 4.42 0.0000 Sex Male 6090 60.22 60900 60.22 0.0000 Female 4023 39.78 40230 39.78 0.0000 Year of incidence 2009 1065 10.53 10650 10.53 0.0000 2010 1005 9.94 10050 9.94 0.0000 2011 1001 9.90 10010 9.90 0.0000 2012 986 9.75 9860 9.75 0.0000 2013 941 9.30 9410 9.30 0.0000 2014 1062 10.50 10620 10.50 0.0000 2015 1053 10.41 10530 10.41 0.0000 2016 851 8.41 8510 8.41 0.0000 2017 809 8.00 8090 8.00 0.0000 2018 688 6.80 6880 6.80 0.0000 2019 652 6.45 6520 6.45 0.0000 Medication- and disease-related risk factors of urolithiasis Medication-related risk factors Diuretics Thiazides 67 0.66 34 0.03 0.1076 Furosemide 321 3.17 146 0.14 0.2392 Potassium-sparing agents 33 0.33 127 0.13 0.0418 Combination of diuretics and potassium-sparing agents 17 0.17 8 0.01 0.0534 Acetazolamide 15 0.15 35 0.03 0.0400 Antiepileptic drugs, AEDs Topiramate 36 0.36 80 0.08 0.0598 Zonisamide - 8 0.01 - Antibiotics Sulfonamides 0 0.00 - Ceftriaxone 102 1.01 146 0.14 0.1153 Trimoxazole 765 7.56 1932 1.91 0.2684 Aminoglycoside 536 5.3 695 0.69 0.2730 Vancomycin 42 0.42 53 0.05 0.0765 Meropenem 30 0.3 14 0.01 0.0738 Quinolones 793 7.84 2254 2.23 0.2587 Antiviral drugs Atazanavir - - - Acyclovir 33 0.33 201 0.2 0.0253 Others Glucocorticoids 2029 20.06 14057 13.9 0.1646 Ephedrine 23 0.23 101 0.1 0.0320 Magnesium trisilicate 5882 58.16 36764 36.35 0.4477 Methotrexate 18 0.18 38 0.04 0.0422 NSAIDs 8785 86.87 63568 62.86 0.5760 Disease-related risk factors Infection Urinary tract or cyst infections 822 8.13 550 0.54 0.3794 Metabolic disorders Hypercalciuria 38 0.38 5 0.00 0.0857 Cystinuria - - - Dyslipidemia 52 0.51 133 0.13 0.0673 Diabetes mellitus 41 0.41 143 0.14 0.0516 Structural abnormality in the renal system Congenital urinary tract anomaly 27 0.27 - - Cystic kidney disease 10 0.1 11 0.01 0.0384 Vesicoureteral reflux (VUR) 32 0.32 17 0.02 0.0729 Ureteropelvic junction obstruction (UPJO) 28 0.28 4 0 0.0749 Gastrointestinal-related disorders Inguinal hernia 20 0.2 64 0.06 0.0389 Inflammatory bowel syndrome 37 0.37 166 0.16 0.0409 Short-bowel/gut syndrome 0 0.00 - - SMD, standardized mean difference; SD, standard deviation; AEDs, antiepileptic drugs; NSAIDs, non-steroidal anti-inflammatory drug; VUR, vesicoureteral reflux; UPJO, ureteropelvic junction obstruction. Table 3. Medication- and disease-related risk factors of pediatric urolithiasis Medication- and disease-related risk factors of urolithiasis OR 95% CI P value aOR 95%CI P value Medication-related risk factors Diuretics Thiazides 19.83 13.12 29.98 <0.001 9.44 5.89 15.14 <0.001 Furosemide 22.67 18.63 27.60 <0.001 14.52 11.63 18.14 <0.001 Potassium-sparing agents 2.61 1.78 3.82 <0.001 0.74 0.44 1.25 0.260 Combination of diuretics and potassium-sparing agents 21.45 9.24 49.77 <0.001 14.26 5.53 36.78 <0.001 Acetazolamide 4.29 2.34 7.86 <0.001 1.93 0.88 4.22 0.100 Antiepileptic drugs (AEDs) Topiramate 4.51 3.04 6.69 <0.001 2.86 1.82 4.49 <.0001 Zonisamide 5.01 1.51 16.63 0.009 3.68 1.01 13.38 0.048 Antibiotics Sulfonamides - - - - - - - - Ceftriaxone 7.05 5.47 9.08 <0.001 2.42 1.76 3.33 <0.001 Trimoxazole 4.21 3.86 4.58 <0.001 2.21 2.00 2.44 <0.001 Aminoglycoside 8.09 7.22 9.08 <0.001 2.97 2.58 3.41 <0.001 Vancomycin 7.96 5.31 11.94 <0.001 0.40 0.21 0.75 0.005 Meropenem 21.49 11.39 40.53 <0.001 0.83 0.34 2.05 0.691 Quinolones 3.73 3.43 4.06 <0.001 2.17 1.98 2.38 <0.001 Antiviral drugs Atazanavir - - - - - - - - Acyclovir 1.64 1.14 2.38 0.008 0.95 0.62 1.45 0.815 Others Glucocorticoids 1.56 1.48 1.64 <0.001 1.08 1.02 1.15 0.006 Ephedrine 2.28 1.45 3.59 <0.001 1.15 0.66 2.00 0.616 Magnesium trisilicate 2.43 2.34 2.54 <0.001 1.63 1.55 1.70 <0.001 Methotrexate 4.74 2.71 8.32 <0.001 0.81 0.36 1.84 0.621 NSAIDs 3.91 3.69 4.15 <0.001 2.79 2.62 2.97 <0.001 Disease-related risk factors Infection Urinary tract or cyst infections 16.17 14.48 18.05 <0.001 8.28 7.33 9.37 <0.001 Metabolic disorders Hypercalciuria 76.27 30.02 193.81 <0.001 31.54 11.37 87.49 <0.001 Cystinuria - - - - - - - - Dyslipidemia 3.93 2.85 5.42 <0.001 2.20 1.47 3.30 <0.001 Diabetes mellitus 2.88 2.03 4.07 <0.001 1.52 0.99 2.36 0.059 Structural abnormality in the renal system Congenital urinary tract anomaly 67.27 23.59 191.83 <0.001 22.58 6.46 78.88 <0.001 Cystic kidney disease 9.10 3.86 21.43 <0.001 8.34 3.25 21.35 <0.001 Vesicoureteral reflux (VUR) 18.88 10.48 34.01 <0.001 1.90 0.85 4.27 0.118 Ureteropelvic junction obstruction (UPJO) 69.55 24.48 197.59 <0.001 19.88 5.88 67.19 <0.001 Gastrointestinal-related disorders Inguinal hernia 3.13 1.90 5.18 <0.001 1.86 1.03 3.36 0.040 Inflammatory bowel syndrome 2.23 1.56 3.19 <0.001 1.68 1.15 2.45 0.008 Short-bowel/gut syndrome - - - - - - - - OR, odds ratio; CI, confidence interval; aOR, adjusted odds ratio; AEDs, antiepileptic drugs; NSAIDs, non-steroidal anti-inflammatory drug; VUR, vesicoureteral reflux; UPJO, ureteropelvic junction obstruction. Table 4. Surgical and pharmacologic management of pediatric urolithiasis Patients with urolithiasis (n = 10113) N % Surgery 821 8.12 Types of surgery Ureteroscopy and removal of ureteral stone with SONO/EHL 615 74.91 Ureteroscopy and removal of ureteral stone with Nd-YAG laser 58 7.06 Ureteroscopy and removal of ureteral stone—simple endoscopy 40 4.87 Ureterolithotomy—upper or distal 1/3 6 0.73 Laparoscopic ureterolithotomy 2 0.24 Cystolithotomy 12 1.46 Simple endoscopic cystolitholapaxy 25 3.05 Complex endoscopic cystolitholapaxy 63 7.67 Drugs used Smooth muscle relaxants Buscopan 960 9.49 Rowapraxin 718 7.1 Urinary alkalinizing agents Potassium citrate 657 6.5 A-adrenergic blockers Tamsulosin 379 3.75 Terazosin 24 0.24 Alfuzosin 12 0.12 Doxazosin 96 0.95 Uric acid-reducing agents Allopurinol 39 0.39 Benzbromarone 90 0.89 Thiazides 96 0.95 SONO/EHL, Endoscopic Ultrasonography (SONO) and Electrohydraulic Lithotripsy (EHL) Supplementary Files Tablesupplement1019.docx Cite Share Download PDF Status: Published Journal Publication published 09 Mar, 2026 Read the published version in Pediatric Nephrology → Version 1 posted Editorial decision: Major Revisions Needed 03 Dec, 2025 Reviewers agreed at journal 16 Nov, 2025 Reviewers invited by journal 13 Nov, 2025 Editor assigned by journal 13 Nov, 2025 First submitted to journal 09 Nov, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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1","display":"","copyAsset":false,"role":"figure","size":41193,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eSelection of cohort with pediatric urolithiasis from the National Health Insurance Research Database (NHIRD).\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFlowchart illustrating the selection of pediatric patients with urolithiasis and matched controls from Taiwan’s National Health Insurance Research Database (NHIRD). In total, 11,576 patients aged 0–18 years who were diagnosed with urolithiasis between 2008 and 2019 were identified. After excluding 1,416 patients diagnosed before 2009 to ensure at least 1-year follow-up, 10,113 children with newly diagnosed urolithiasis between 2009 and 2018 were included in the final cohort. For each case, 10 control participants without a urolithiasis diagnosis were frequency-matched by age, sex, and index year, resulting in a comparison group of 101,130 individuals.\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-8075378/v1/13a6ba72d98a3d75c9eb4981.png"},{"id":96790195,"identity":"90d3135a-065d-42c3-a414-1805b870b3f1","added_by":"auto","created_at":"2025-11-26 06:53:01","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":148744,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eAnnual incidence trends in pediatric urolithiasis in Taiwan, 2009–2019.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAnnual incidence rates of pediatric urolithiasis per 100,000 persons stratified by sex (male, female) and overall population. The overall incidence (black squares) declined from 20.78 per 100,000 persons in 2009 to 16.22 per 100,000 persons in 2019. Male patients (blue circles) consistently had higher incidence rates than female ones (red diamonds), with a peak rate of 27.48 per 100,000 persons in 2015, followed by a gradual decline thereafter. These findings indicate a male predominance and a modest downward trend in pediatric urolithiasis over the last decade.\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-8075378/v1/2b53fd60d4e3777086e7edf4.png"},{"id":104739341,"identity":"3bbbbb75-dac3-44fa-a049-1fe504c24d06","added_by":"auto","created_at":"2026-03-16 16:03:13","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":2213422,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8075378/v1/28dd7ef8-03b1-47f7-a694-30d896040e9b.pdf"},{"id":96790197,"identity":"f644ff2f-193b-475b-8901-974799cf3ef2","added_by":"auto","created_at":"2025-11-26 06:53:01","extension":"docx","order_by":7,"title":"","display":"","copyAsset":false,"role":"supplement","size":23123,"visible":true,"origin":"","legend":"","description":"","filename":"Tablesupplement1019.docx","url":"https://assets-eu.researchsquare.com/files/rs-8075378/v1/c1e8508e6f9f714e437ec862.docx"}],"financialInterests":"","formattedTitle":"Nationwide cohort analysis of pediatric urolithiasis: long-term metabolic, renal, and cardiovascular outcomes","fulltext":[{"header":"Introduction","content":"\u003cp\u003ePediatric urolithiasis, which was previously considered a localized urinary disorder, is now increasingly recognized as part of a systemic process characterized by metabolic dysregulation and chronic low-grade inflammation [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Recent adult studies have shown associations between stone disease, hypertension, dyslipidemia, insulin resistance, and endothelial dysfunction, indicating shared pathogenic pathways between nephrolithiasis and cardiovascular\u0026ndash;renal injury [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. However, such systemic associations remain underexplored in children, in whom early metabolic disturbances may have long-term consequences for renal and vascular health.\u003c/p\u003e\u003cp\u003eGlobally, the incidence of pediatric urolithiasis has increased, reflecting changes in dietary habits, sedentary behavior, and climate [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. Metabolic disorders account for 33%\u0026ndash;95% of cases. Meanwhile, anatomic malformations and infections contribute to 8%\u0026ndash;32% and 2%\u0026ndash;24%, respectively [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. Despite advancements in metabolic screening and infection control, occult nephrolithiasis may still present with recurrent symptoms and abnormal urinary solutes even in the absence of imaging evidence [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. Beyond morbidity and recurrence, stone disease has emerged as a systemic condition associated with renal and cardiovascular complications in both adults and adolescents [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e].\u003c/p\u003e\u003cp\u003ePrevious population-based studies from Taiwan reported a 0.038% incidence of pediatric urolithiasis in 2007, with a peak occurrence during adolescence and a declining trend in incidence and healthcare utilization over time. Moreover, male patients exhibited an increasing frequency of upper urinary tract stone visits and higher recurrence rates (6.12% at 1 year and 34.71% at 5 years) [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. Nevertheless, comprehensive data on nationwide trends, predisposing factors, and long-term systemic outcomes in pediatric populations remain lacking. Using the National Health Insurance Research Database (NHIRD), which covers nearly the whole Taiwanese population, the current study aimed to investigate the epidemiology, metabolic and structural risk factors, and systemic complications\u0026mdash;spanning renal, cardiovascular, and metabolic domains\u0026mdash;of pediatric urolithiasis.\u003c/p\u003e"},{"header":"Materials and Methods","content":"\u003cp\u003e\u003cstrong\u003eStudy Design and Data Sources\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis population-based retrospective cohort study used data from the Taiwan NHIRD, which includes medical information on more than 23 million residents. Patient records from Jan. 2009 to Dec. 2018 were obtained via the Health and Welfare Data Science Center [11, 12]. Urolithiasis cases were identified using diagnostic codes from both the \u003cem\u003eInternational Classification of Diseases, Ninth Revision, Clinical Modification\u003c/em\u003e (ICD-9-CM, 2009\u0026ndash;2015) and \u003cem\u003eTenth Revision\u003c/em\u003e (ICD-10-CM, 2016 onward). Annual incidence rates were calculated using population data from the Ministry of the Interior\u0026rsquo;s Public Birth Registry.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical Approval and Study Population\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe current study was conducted in accordance with the Declaration of Helsinki and approved by the Institutional Review Board of Hualien Tzu Chi Hospital (IRB111-023-B, April 21, 2022). The need for informed consent was waived owing to the retrospective nature of the study.\u003c/p\u003e\n\u003cp\u003eThe pediatric urolithiasis cohort included patients with a primary diagnosis of urolithiasis (ICD-9-CM codes: 592, 594, 274.11, and 788.0; ICD-10-CM codes: N13.2, N20.0\u0026ndash;N20.2, N21, and N23) who had at least one hospitalization or two outpatient visits. The date of the first diagnosis was defined as the index date [11]. Patients with invalid or missing data were excluded from the analysis.\u003c/p\u003e\n\u003cp\u003eChildren with pre-index predisposing factors were categorized into the disease- or medication-related groups. Medication exposure was assessed using the Anatomical Therapeutic Chemical (ATC) Classification System, focusing on prolonged use (\u0026gt;30 days) of potential causative drugs. Patients with pre-existing comorbidities were included in the baseline analyses but excluded from the assessment of complication outcomes. Controls were randomly selected from the remaining NHIRD population and matched at a ratio of 1:10 according to sex, age, and index year (2009\u0026ndash;2019), using identical exclusion criteria.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAssessment of Urolithiasis-Related Complications\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe complications associated with renal, cardiovascular, and metabolic systems in both the urolithiasis and control groups were evaluated [7, 8]. Eligible events were defined as at least one hospitalization or two outpatient visits for the corresponding ICD-9/ICD-10 diagnoses occurring \u0026ge;30 days after the index date. \u003cem\u003eSupplementary Table S1\u0026nbsp;\u003c/em\u003eshows\u003cem\u003e\u0026nbsp;\u003c/em\u003ethe diagnostic, drug, and surgical codes used in this study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEvaluation of Treatment Modalities\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe treatment strategies, including surgical and pharmacologic interventions, were identified using the ICD-9/ICD-10 procedure codes and ATC drug classifications. The surgical procedures included endoscopic cystolitholapaxy (78024C, 78026C, and 78027C), ureteroscopy with stone removal (77026B, 77027B, and 77028B), ureterolithotomy (77001B, 77002B, and 77030B), percutaneous nephrostolithotomy (76016B, 76017B), and cystolithotomy (78005B) [13].\u003c/p\u003e\n\u003cp\u003eThe pharmacologic treatments were identified using ATC codes for agents commonly prescribed for urolithiasis [14, 15]:\u003c/p\u003e\n\u003cul type=\"disc\"\u003e\n \u003cli\u003e\u003cstrong\u003eDiuretics:\u003c/strong\u003e thiazides (C03A)\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eAlpha-adrenergic blockers:\u003c/strong\u003e G04CA01\u0026ndash;G04CA04\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eSmooth muscle relaxants:\u003c/strong\u003e \u003cem\u003ehyoscine butylbromide\u003c/em\u003e (Buscopan, A03BB01) and \u003cem\u003eRowapraxin\u003c/em\u003e (G04BD)\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eUric acid-lowering agents:\u003c/strong\u003e \u003cem\u003eallopurinol\u003c/em\u003e (M04AA012), \u003cem\u003ebenzbromarone\u003c/em\u003e (M04AB03)\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eUrinary alkalinizing agents:\u003c/strong\u003e \u003cem\u003epotassium citrate\u003c/em\u003e (A12BA02)\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003ePatients who had used these medications for \u0026gt;30 days prior to the index date were excluded to prevent confounding by previous treatment. Only patients who were newly prescribed with medications for \u0026gt;30 days after diagnosis were included in the analysis [11].\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStatistical Analysis\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe annual incidence rates stratified by age and sex were calculated using population data from the Ministry of the Interior. Descriptive statistics were presented as counts and percentages. The incidence rates were compared using the chi-square test. Univariate and multivariate Cox proportional hazards models were used to estimate adjusted hazard ratios (aHRs) for complications. All analyses were conducted using SAS version 9.4 (SAS Institute Inc., Cary, NC, the USA). A two-tailed P value of \u0026lt;0.05 was considered statistically significant.\u003c/p\u003e"},{"header":"Results","content":"\u003ch2\u003eDemographic Characteristics of the Participants\u003c/h2\u003e\n\u003cp\u003eFrom 2008 to 2019, 11,576 pediatric patients were diagnosed with urolithiasis in Taiwan (Figure 1). After excluding patients diagnosed before 2009 (n = 1,416), 10,113 patients who were newly diagnosed between 2009 and 2018 and 101,130 age- and sex-matched controls were included in the analysis. The participants were followed-up until event occurrence, death, or December 31, 2019.\u003c/p\u003e\n\u003cp\u003eThe annual incidence of pediatric urolithiasis declined from 23.85 to 16.22 per 100,000 persons, yielding an overall cumulative rate of 20.25 per 100,000 (Figure 2). The mean age at diagnosis was 14.4 \u0026plusmn; 4.4 years, and the male-to-female ratio was 1.5:1. As shown in \u003cstrong\u003eTable 1\u003c/strong\u003e, patients with urolithiasis had a higher exposure to several medications than controls. The most evident standardized mean differences were observed for diuretics (thiazides: 0.108, furosemide: 0.239), antimicrobials (ceftriaxone: 0.115, trimethoprim\u0026ndash;sulfamethoxazole: 0.268, aminoglycosides: 0.273, and quinolones: 0.259), and other drugs (glucocorticoids: 0.165, magnesium trisilicate: 0.448, and nonsteroidal anti-inflammatory drugs [NSAIDs]: 0.576). The standardized mean differences for the presence of disease-related factors such as urinary tract and cyst infections were also significantly high (0.379).\u003c/p\u003e\n\u003cp\u003eThe multivariate regression analysis (\u003cstrong\u003eTable 2\u003c/strong\u003e) showed several independent risk factors. Among medication-related exposures, diuretics\u0026mdash;including thiazides (aHR: 9.44), furosemide (aHR: 14.52), and combination of potassium-sparing agents (aHR: 14.26)\u0026mdash;were strongly associated with urolithiasis. Patients who were taking antiepileptic drugs including topiramate (aHR: 2.86) and zonisamide (aHR: 3.68) were also at higher risks for urolithiasis. Antibiotics such as ceftriaxone (aHR: 2.42, P \u0026lt; 0.001), trimethoprim\u0026ndash;sulfamethoxazole (aHR: 2.21, P \u0026lt; 0.001), aminoglycosides (aHR: 2.97, P \u0026lt; 0.001), and quinolones (aHR: 2.17, P \u0026lt; 0.001) were significantly associated with urolithiasis. The other contributors included glucocorticoids (aHR: 1.08), magnesium trisilicate (aHR: 1.63), and NSAIDs (aHR: 2.79). Disease-related factors such as hypercalciuria (aHR: 31.54), ureteropelvic junction obstruction (aHR: 19.88), congenital urinary tract anomalies (aHR: 22.58), and urinary tract infections (aHR: 8.28) had the strongest associations with urolithiasis.\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eComplications\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eRenal complications\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eChildren with urolithiasis were significantly at higher risks for renal complications compared with controls (\u003cstrong\u003eTable 3\u003c/strong\u003e). Hematuria had the largest increase (724.6 vs. 34.8 per 100,000 person-years, IRR: 20.84, P \u0026lt; 0.001), followed by chronic kidney disease (13.5 vs. 2.0, IRR: 6.63, P \u0026lt; 0.001) and urinary tract/cyst infections (876.1 vs. 164.3, IRR: 5.33, P \u0026lt; 0.001). The other complications included enuresis (5.6 vs. 1.7, IRR: 3.31, P \u0026lt; 0.001) and proteinuria (68.4 vs. 31.1, IRR: 2.20, P \u0026lt; 0.001). The multivariate analyses confirmed significant aHRs for hematuria (17.76, 95% confidence interval [CI]: 15.28\u0026ndash;20.65), chronic kidney disease (5.92, 95% CI: 3.08\u0026ndash;11.35), urinary tract/cyst infections (4.57, 95% CI: 4.21\u0026ndash;4.96), enuresis (3.16), and proteinuria (2.16).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCardiovascular complications\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eChildren with urolithiasis had significantly higher incidence rates of cardiovascular events. The most notable increases were for congestive heart failure (14.1 vs. 4.4, IRR: 3.21, P \u0026lt; 0.001), hypertension (61.3 vs. 24.0, IRR: 2.56, P \u0026lt; 0.001), ischemic stroke (4.9 vs. 2.0, IRR: 2.42, P \u0026lt; 0.001), and ischemic heart disease (8.0 vs. 3.4, IRR: 2.36, P \u0026lt; 0.001). The multivariate Cox models showed increased adjusted risks for congestive heart failure (aHR: 2.45, 95% CI: 1.49\u0026ndash;4.04, P \u0026lt; 0.001), hypertension (aHR: 1.92, 95% CI: 1.11\u0026ndash;4.90, P \u0026lt; 0.001), and ischemic heart disease (aHR: 1.93, 95% CI: 1.07\u0026ndash;3.47, P = 0.03).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMetabolic complications\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe cohort with urolithiasis presented with elevated incidence rates of metabolic syndrome (3.1 vs. 0.9 per 100,000 person-years) and dyslipidemia (95.9 vs. 48.9, P \u0026lt; 0.001). Adjusted analyses confirmed higher risks for metabolic syndrome (aHR: 4.15, 95% CI: 1.39\u0026ndash;12.44, P = 0.01) and dyslipidemia (aHR: 1.83, 95% CI: 1.56\u0026ndash;2.15, P \u0026lt; 0.001), as shown in Table 3.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTreatment Patterns\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAmong the 10,113 pediatric patients, 821 (8.1%) received surgical intervention. The majority of patients underwent ureteroscopy with stone removal (7.0%), followed by endoscopic cystolitholapaxy (0.9%), cystolithotomy (0.1%), and ureterolithotomy (0.08%).\u003cbr\u003eApproximately 30% of patients received pharmacologic therapy. Smooth muscle relaxants\u0026mdash;\u003cem\u003ehyoscine butylbromide\u003c/em\u003e (9.5%) and \u003cem\u003eRowapraxin\u003c/em\u003e (7.1%)\u0026mdash;were most commonly prescribed, followed by urinary alkalinizing agents such as potassium citrate (6.5%) and alpha-adrenergic blockers. Preventive medications including thiazide diuretics and uric acid-lowering agents were not frequently used. The surgical\u0026nbsp;and pharmacologic managements\u0026nbsp;of pediatric urolithiasis\u0026nbsp;were listed in \u003cstrong\u003eTable 4\u003c/strong\u003e.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis nationwide study provides the largest population-based assessment of pediatric urolithiasis in Taiwan. Although its incidence has declined modestly during the past decade, affected children exhibit substantially increased risks of renal, cardiovascular, and metabolic complications. These findings underscore that pediatric urolithiasis is not merely a transient urinary condition, but a systemic disorder with long-term health implications.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEtiologic Heterogeneity and Metabolic Risk\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eUnlike adult stone disease, which is often related to environmental and dietary factors, pediatric urolithiasis is primarily caused by metabolic disturbances, congenital anomalies, and infections [5, 16]. In our cohort, hypercalciuria was the most prominent risk factor, conferring a 31-fold higher risk of stone formation, which is consistent with previous studies identifying calcium handling defects as the main underlying mechanism [5, 6]. Dyslipidemia further increased the risk (aHR 2.2), suggesting that lipid dysregulation and oxidative stress contribute to tubular injury and crystal adhesion via the osteopontin-related pathways [8, 17, 18]. These findings support comprehensive metabolic screening even after the first episode of urolithiasis in children.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStructural and Infectious Contributors\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eStructural abnormalities such as ureteropelvic junction obstruction, vesicoureteral reflux, and cystic kidney disease further predispose to urinary stasis and infection [5]. In our analysis, congenital urinary anomalies and ureteropelvic junction obstruction increased the risk of stone formation by 22.6- and 19.9-fold, respectively. The coexistence of metabolic and structural abnormalities\u0026mdash;as observed in up to 80% of affected children [5]\u0026mdash;likely acts synergistically to enhance the risk of crystallization by combining urinary retention with altered solute composition. Urinary tract infection (UTI) remains another important contributor: urease-producing organisms elevate urinary pH and ammonium, promoting struvite stone formation [19]. Our data showed an 8.3-fold higher risk of urolithiasis in children with a previous UTI, consistent with earlier Taiwanese reports [20, 21]. Chronic infection and inflammation may also increase reactive oxygen species, accelerating crystal nucleation and tubular injury [22]. Furthermore, \u003cstrong\u003esystemic conditions such as inflammatory bowel disease are associated with an increased stone risk (renal stone prevalence: 6.3%) [\u003c/strong\u003e22\u003cstrong\u003e], caused by bile salt and fat malabsorption that alters oxalate metabolism and by reduced urinary volume and citrate levels [23]. Disease severity, surgery, and antitumor necrosis factor therapy may further compound this risk.\u0026nbsp;\u003c/strong\u003eThese findings underscore the multifactorial nature of pediatric urolithiasis, in which metabolic, structural, infectious, and systemic conditions interact to promote stone formation.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMedication-Related Risks and Clinical Stewardship\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eMedication exposure is another modifiable risk domain. Diuretics, antiepileptic agents, antibiotics, and NSAIDs were independently associated with the development of urolithiasis. Loop diuretics such as furosemide are associated with a 14.5-fold increased risk, likely due to calcium mobilization and hypercalciuria [24]. Thiazides\u0026mdash;which are traditionally used to prevent recurrence\u0026mdash;showed a paradoxical association with stone risk, possibly reflecting metabolic disturbances or confounding by indication [25]. Broad-spectrum antibiotics may alter gut microbiota, reducing \u003cem\u003eOxalobacter formigenes\u003c/em\u003e and enhancing oxalate absorption [5, 19]. NSAIDs, linked to renal papillary necrosis [26], increased 2.8-fold of urolithiasis risk.\u0026nbsp;Further, carbonic anhydrase inhibitors (topiramate, zonisamide) and glucocorticoids modify urinary pH, calcium, and uric acid metabolism, thereby increasing crystal formation propensity [24]. These findings emphasize that even therapeutic exposures can alter the renal milieu toward lithogenesis and should be cautiously considered in clinical practice.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsidering these multiple risk factors, management strategies must be individualized.\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eMost neonatal nephrocalcinosis and small stones resolve spontaneously [21]. Stone size remains a key determinant of stone management. In particular, stones measuring \u0026lt;4 mm often pass spontaneously, while those measuring \u0026gt;5 mm usually require intervention [15]. In our cohort, 8.12% of patients required surgery, and this value was comparable to that of a previous Taiwanese study (7.6%) [20]. Ureteroscopy was the most common procedure (86.85%), followed by endoscopic cystolitholapaxy (10.72%), cystolithotomy (1.46%), and ureterolithotomy (0.97%). Pharmacologic therapy is an important adjunct. Evidence on the use of medical expulsive therapy in children is limited [15]. However, agents such as Buscopan and Rowapraxin may relieve ureteral spasm, and tamsulosin facilitates the passage of small stones. Potassium citrate reduces recurrence by lowering urinary calcium levels and increasing pH, and uric acid-lowering agents combined with thiazides may further prevent stone formation [14]. In our cohort, the commonly used medications included Buscopan (9.49%), Rowapraxin (7.1%), potassium citrate (6.5%), and tamsulosin (3.75%). These findings emphasize the need for management strategies individualized based on stone size and metabolic profile, integrating pharmacologic therapy to prevent recurrence and improve outcomes.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSystemic Outcomes and Clinical Significance\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eBeyond local kidney injury, our findings revealed that pediatric urolithiasis carries important systemic consequences. Hematuria, which is observed in nearly 90% of cases, is caused by mechanical urothelial irritation and oxidative stress-induced microvascular fragility [15]. In our cohort, the incidence of hematuria was significantly elevated (IRR: 20.8, aHR: 17.8), and the condition frequently recurred, reflecting ongoing inflammatory stress. Proteinuria, a marker of glomerular hyperfiltration and tubular dysfunction, was twice as common in stone formers (aHR: 2.16), thereby supporting its role as an early indicator of progressive nephron injury [8]. Persistent proteinuria may further aggravate glomerulosclerosis and tubulointerstitial fibrosis, reinforcing the chronicity of kidney damage.\u003c/p\u003e\n\u003cp\u003eUTI also displayed a bidirectional relationship with urolithiasis: stones promote bacterial adherence and obstruction. Meanwhile, infection facilitates struvite formation and inflammation [27]. Repeated infection maintains oxidative injury, thereby promoting a cycle of inflammation and fibrosis. Thus, chronic kidney disease emerges as a major long-term outcome; stone disease accounts for up to 8% of childhood kidney failure cases [28, 29]. In our cohort, the risk of chronic kidney disease was nearly 6-fold higher among stone formers. The mechanisms likely involve repeated obstruction, infection, and inflammatory insult, which reduce nephron number and renal reserve [30]. Interestingly, enuresis was more frequently observed in affected children (IRR: 3.31, aHR: 3.16), possibly reflecting impaired tubular water handling, reduced urine concentration ability, and autonomic dysregulation of bladder\u0026ndash;sphincter coordination [31, 32].\u003c/p\u003e\n\u003cp\u003eThe systemic nature of pediatric urolithiasis extends to cardiovascular and metabolic domains. Our study showed higher incidences of metabolic syndrome (IRR: 3.61, aHR: 4.15) and dyslipidemia (IRR: 1.96, aHR: 1.83) in affected children. This finding is similar to that of adult studies linking nephrolithiasis with insulin resistance and lipid metabolism disturbances [17]. Chronic inflammation and oxidative stress may represent the shared biological axis linking stone formation with endothelial dysfunction, reduced nitric oxide bioavailability, and vascular stiffness [33-35]. Inflammatory cytokines and activated macrophages, which are key mediators of atherosclerosis and cardiac remodeling [36, 37], may contribute to early vascular injury in this population. Consistent with adult data, our pediatric cohort exhibited two- to threefold higher risks of hypertension and ischemic heart disease [3, 8, 38]. Collectively, these findings support the concept that pediatric stone disease may be an early manifestation of systemic vascular vulnerability. The recognition of pediatric urolithiasis as a systemic metabolic\u0026ndash;inflammatory disorder has several clinical implications. Routine follow-up of affected children should include not only imaging surveillance for recurrence but also laboratory assessment for proteinuria and dyslipidemia and blood pressure monitoring. Preventive strategies that aimed to reduce oxidative stress, improve endothelial function, and address modifiable metabolic risk factors\u0026mdash;such as dietary habit, obesity, and physical inactivity\u0026mdash;may attenuate long-term cardiovascular and renal complications [39].\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStrengths and Limitations\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe strengths of this study include the inclusion of a large, nationally representative cohort and the implementation of a long-term follow-up, which allows for a robust assessment of both renal and systemic outcomes. Nonetheless, the current study had several limitations that should be acknowledged. The NHIRD lacks information on urinary biochemical parameters, stone composition, dietary habit, and imaging findings, precluding a detailed analysis of metabolic phenotypes and recurrence. Genetic predispositions and unmeasured lifestyle factors may also contribute to residual confounding.\u003c/p\u003e\n\u003cp\u003eIn conclusion, the incidence of pediatric urolithiasis in Taiwan has shown a gradual decline. However, the condition remains strongly associated with substantial renal, cardiovascular, and metabolic morbidity. These findings reinforce the emerging view that urolithiasis represents a systemic disorder driven by intertwined inflammatory and metabolic pathways. Early metabolic assessment and multidisciplinary preventive care are important for preserving long-term kidney function and mitigating cardiovascular risk in this vulnerable population.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eFunding:\u003c/strong\u003e This work was supported by the Tzu Chi Medical Foundation, Taiwan (Grant number TCCF110195A).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests:\u0026nbsp;\u003c/strong\u003eThe authors have no relevant financial or non-financial interests to disclose.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval:\u0026nbsp;\u003c/strong\u003eThe study was conducted in accordance with the Declaration of Helsinki and approved by the Institutional Review Board of Hualien Tzu Chi Hospital (IRB111-023-B, April 21, 2022).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent:\u0026nbsp;\u003c/strong\u003eThe need for informed consent was waived owing to the retrospective nature of the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData sharing statement:\u0026nbsp;\u003c/strong\u003eAll data generated or analyzed during this study are included in this published article.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; contribution:\u0026nbsp;\u003c/strong\u003eM. C. C., J. W. L., and H. J. H. conceived and designed the study. W. -T. H. and J. -H. W. prepared the materials and collected the data. H. -H. Y., W. -T. H., J. -H. W., and M. -C. C. analyzed and interpreted the patient data. H. -H. Y. and M. -C. C. wrote the first draft of the manuscript, and all authors commented on the previous versions of the manuscript. All the authors have read and approved the final version of the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDeclaration of Generative AI and AI-assisted technologies in the writing process\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eDuring the preparation of this work, the authors used \u003cstrong\u003eChatGPT (OpenAI)\u003c/strong\u003e to assist in refining the English language and improving the clarity and logical flow of the manuscript. After using this tool, the author(s) thoroughly reviewed, revised, and verified all contents to ensure accuracy and originality, and take full responsibility for the final version of the manuscript.\u003c/p\u003e"},{"header":"References","content":"\u003col start=\"1\" type=\"1\"\u003e\n\u003cli\u003eGambaro A, Lombardi G, Caletti C et al (2022) Nephrolithiasis: a red flag for cardiovascular risk. J Clin Med 11:5512. https://doi.org/10.3390/jcm11195512\u003c/li\u003e\n\u003cli\u003eHuang K, Peng Z, Zha C et al (2024) Inflammatory factors and the risk of urolithiasis: a bidirectional Mendelian randomization study. Front Med 11:1432275. https://doi.org/10.3389/fmed.2024.1432275\u003c/li\u003e\n\u003cli\u003ePeng JP, Zheng H (2017) Kidney stones may increase the risk of coronary heart disease and stroke: a PRISMA-compliant meta-analysis. 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PLoS One 19:e0301545. https://doi.org/10.1371/journal.pone.0301545\u003c/li\u003e\n\u003cli\u003eDaudon M, Frochot V, Bazin D, Jungers P (2018) Drug-induced kidney stones and crystalline nephropathy: pathophysiology, prevention and treatment. Drugs 78:163\u0026ndash;201. https://doi.org/10.1007/s40265-017-0853-7\u003c/li\u003e\n\u003cli\u003eBargagli M, Anderegg MA, Fuster DG (2024) Effects of thiazides and new findings on kidney stones and dysglycemic side effects. Acta Physiol 240:e14155. https://doi.org/10.1111/apha.14155\u003c/li\u003e\n\u003cli\u003eEl-Reshaid K, Al-Bader S, Sallam H (2021) Recurrent papillary necrosis and nephrocalcinosis induced by nonsteroidal anti-inflammatory drugs for gouty arthritis associated with congenital chloride-losing diarrhea: a major risk for kidney loss. Case Rep Nephrol 2021:3558278. https://doi.org/10.1155/2021/3558278\u003c/li\u003e\n\u003cli\u003eCetin N, Gencler A, Kavaz Tufan A (2020) Risk factors for development of urinary tract infection in children with nephrolithiasis. J Paediatr Child Health 56:76\u0026ndash;80. https://doi.org/10.1111/jpc.14495\u003c/li\u003e\n\u003cli\u003eRule AD, Krambeck AE, Lieske JC (2011) Chronic kidney disease in kidney stone formers. Clin J Am Soc Nephrol 6:2069\u0026ndash;2075. https://doi.org/10.2215/cjn.10651110\u003c/li\u003e\n\u003cli\u003e\u0026Ccedil;altik Yilmaz A, \u0026Uuml;nal N, \u0026Ccedil;elebi Tayfur A, B\u0026uuml;y\u0026uuml;kkarag\u0026ouml;z B (2022) How important urolithiasis is under 2 years of age? Urolithiasis 50:159\u0026ndash;165. https://doi.org/10.1007/s00240-021-01295-x\u003c/li\u003e\n\u003cli\u003eZeng G, Zhu W, Somani B et al (2024) International Alliance of Urolithiasis (IAU) guidelines on the management of pediatric urolithiasis. Urolithiasis 52:124. https://doi.org/10.1007/s00240-024-01621-z\u003c/li\u003e\n\u003cli\u003eChung HJ, Lin ATL, Lin CC, Chen TJ, Chen KK (2016) Patients with urinary incontinence appear more likely to develop upper urinary tract stones: a nationwide, population-based study with 8-year follow-up. PLoS One 11:e0161223. https://doi.org/10.1371/journal.pone.0161223\u003c/li\u003e\n\u003cli\u003eNoval Rivas M, Arditi M (2023) Kawasaki disease and multisystem inflammatory syndrome in children. Rheum Dis Clin North Am 49:647\u0026ndash;659. https://doi.org/10.1016/j.rdc.2023.03.002\u003c/li\u003e\n\u003cli\u003eKhan SR (2013) Reactive oxygen species as the molecular modulators of calcium oxalate kidney stone formation: evidence from clinical and experimental investigations. 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Medicina 59:1895. https://doi.org/10.3390/medicina59111895\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"7\" valign=\"top\"\u003e\n \u003cp\u003eTable 1. Baseline demographic characteristics and medication- and disease-related risk factors of pediatric patients with and without urolithiasis\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" rowspan=\"3\" valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003ePatients with urolithiasis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003ePatients without urolithiasis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003eSMD\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e(n = 10113)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e (n = 101130)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eN\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e N\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge (mean, SD)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e14.42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e4.42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e 14.42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e4.42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.0000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"7\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eSex\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e6090\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e60.22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e 60900\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e60.22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.0000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e4023\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e39.78\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e 40230\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e39.78\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.0000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"7\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eYear of incidence\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2009\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1065\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e10.53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e 10650\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e10.53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.0000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2010\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1005\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e9.94\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e 10050\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e9.94\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.0000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2011\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e9.90\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e 10010\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e9.90\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.0000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2012\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e986\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e9.75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e 9860\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e9.75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.0000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2013\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e941\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e9.30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e 9410\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e9.30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.0000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2014\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1062\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e10.50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e 10620\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e10.50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.0000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2015\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1053\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e10.41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e 10530\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e10.41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.0000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2016\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e851\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e8.41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e 8510\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e8.41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.0000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2017\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e809\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e8.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e 8090\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e8.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.0000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2018\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e688\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e6.80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e 6880\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e6.80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.0000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2019\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e652\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e6.45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e 6520\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e6.45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.0000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"7\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eMedication- and disease-related risk factors of urolithiasis\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"7\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003e\u0026nbsp;Medication-related risk factors\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"6\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eDiuretics\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eThiazides\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e 34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.1076\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eFurosemide\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e321\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e3.17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e 146\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.2392\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003ePotassium-sparing agents\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e 127\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.0418\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eCombination of diuretics and potassium-sparing agents\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e 8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.0534\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eAcetazolamide\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e 35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.0400\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"6\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eAntiepileptic drugs, AEDs\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eTopiramate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e 80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.0598\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eZonisamide\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e 8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"6\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eAntibiotics\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eSulfonamides\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eCeftriaxone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e102\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e 146\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.1153\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eTrimoxazole\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e765\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e7.56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e 1932\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1.91\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.2684\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eAminoglycoside\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e536\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e5.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e 695\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.69\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.2730\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eVancomycin\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e 53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.0765\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eMeropenem\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e 14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.0738\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eQuinolones\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e793\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e7.84\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e 2254\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2.23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.2587\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"6\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eAntiviral drugs\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eAtazanavir\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e -\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eAcyclovir\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e 201\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.0253\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"6\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eOthers\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eGlucocorticoids\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2029\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e20.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e 14057\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e13.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.1646\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eEphedrine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e 101\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.0320\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eMagnesium trisilicate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e5882\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e58.16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e 36764\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e36.35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.4477\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eMethotrexate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e 38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.0422\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNSAIDs\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e8785\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e86.87\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e 63568\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e62.86\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.5760\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"7\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eDisease-related risk factors\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eInfection\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eUrinary tract or cyst infections\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e822\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e8.13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e 550\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.3794\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"6\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eMetabolic disorders\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eHypercalciuria\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e 5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.0857\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eCystinuria\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e -\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eDyslipidemia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e52\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.51\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e 133\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.0673\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eDiabetes mellitus\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e 143\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.0516\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"6\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eStructural abnormality in the renal system\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eCongenital urinary tract anomaly\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e -\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eCystic kidney disease\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e 11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.0384\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eVesicoureteral reflux (VUR)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e 17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.0729\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eUreteropelvic junction obstruction (UPJO)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e 4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.0749\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eGastrointestinal-related disorders\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eInguinal hernia\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e 64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.0389\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eInflammatory bowel syndrome\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e 166\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.0409\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eShort-bowel/gut syndrome\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e -\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eSMD, standardized mean difference; SD, standard deviation; AEDs, antiepileptic drugs; NSAIDs, non-steroidal anti-inflammatory drug; VUR, vesicoureteral reflux; UPJO, ureteropelvic junction obstruction.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003cimg src=\"https://myfiles.space/user_files/58895_8739fc6c57c1c19a/58895_custom_files/img1764089807.png\" width=\"747\" height=\"750\"\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"104%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"11\" valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003eTable 3. Medication- and disease-related risk factors of pediatric urolithiasis\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"11\" valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMedication- and disease-related risk factors of urolithiasis\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 30px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003eOR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e95% CI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003eP value\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003eaOR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e95%CI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003eP value\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"11\" valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eMedication-related risk factors\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 2px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"10\" valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDiuretics\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 2px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 2px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25px;\"\u003e\n \u003cp\u003eThiazides\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e19.83\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e13.12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e29.98\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e9.44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e5.89\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e15.14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 2px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 2px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25px;\"\u003e\n \u003cp\u003eFurosemide\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e22.67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e18.63\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e27.60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e14.52\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e11.63\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e18.14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 2px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 2px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25px;\"\u003e\n \u003cp\u003ePotassium-sparing agents\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e2.61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.78\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e3.82\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0.74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e0.44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e1.25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e0.260\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 2px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 2px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25px;\"\u003e\n \u003cp\u003eCombination of diuretics and potassium-sparing agents\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e21.45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e9.24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e49.77\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e14.26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e5.53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e36.78\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 2px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 2px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25px;\"\u003e\n \u003cp\u003eAcetazolamide\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e4.29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e2.34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e7.86\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.93\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e0.88\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e4.22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e0.100\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 2px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"10\" valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAntiepileptic drugs (AEDs)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 2px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 2px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25px;\"\u003e\n \u003cp\u003eTopiramate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e4.51\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e3.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e6.69\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e2.86\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e1.82\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e4.49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;.0001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 2px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 2px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25px;\"\u003e\n \u003cp\u003eZonisamide\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e5.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.51\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e16.63\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.009\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e3.68\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e1.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e13.38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.048\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 2px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"10\" valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAntibiotics\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 2px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 2px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25px;\"\u003e\n \u003cp\u003eSulfonamides\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 2px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 2px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25px;\"\u003e\n \u003cp\u003eCeftriaxone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e7.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e5.47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e9.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e2.42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e1.76\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e3.33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 2px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 2px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25px;\"\u003e\n \u003cp\u003eTrimoxazole\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e4.21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e3.86\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e4.58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e2.21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e2.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e2.44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 2px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 2px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25px;\"\u003e\n \u003cp\u003eAminoglycoside\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e8.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e7.22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e9.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e2.97\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e2.58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e3.41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 2px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 2px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25px;\"\u003e\n \u003cp\u003eVancomycin\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e7.96\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e5.31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e11.94\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0.40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e0.21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e0.75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.005\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 2px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 2px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25px;\"\u003e\n \u003cp\u003eMeropenem\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e21.49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e11.39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e40.53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0.83\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e0.34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e2.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e0.691\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 2px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 2px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25px;\"\u003e\n \u003cp\u003eQuinolones\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e3.73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e3.43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e4.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e2.17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e1.98\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e2.38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 2px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"10\" valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAntiviral drugs\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 2px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 2px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25px;\"\u003e\n \u003cp\u003eAtazanavir\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 2px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 2px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25px;\"\u003e\n \u003cp\u003eAcyclovir\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e2.38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e0.008\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0.95\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e0.62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e1.45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e0.815\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 2px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"10\" valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOthers\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 2px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 2px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25px;\"\u003e\n \u003cp\u003eGlucocorticoids\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e1.64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e1.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e1.15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.006\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 2px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 2px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25px;\"\u003e\n \u003cp\u003eEphedrine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e2.28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e3.59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e0.66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e2.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e0.616\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 2px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 2px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25px;\"\u003e\n \u003cp\u003eMagnesium trisilicate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e2.43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e2.34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e2.54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.63\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e1.55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e1.70\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 2px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 2px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25px;\"\u003e\n \u003cp\u003eMethotrexate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e4.74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e2.71\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e8.32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0.81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e0.36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e1.84\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e0.621\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 2px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 2px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25px;\"\u003e\n \u003cp\u003eNSAIDs\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e3.91\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e3.69\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e4.15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e2.79\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e2.62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e2.97\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"11\" valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eDisease-related risk factors\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 2px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"10\" valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eInfection\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 2px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 2px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25px;\"\u003e\n \u003cp\u003eUrinary tract or cyst infections\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e16.17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e14.48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e18.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e8.28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e7.33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e9.37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 2px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"10\" valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;Metabolic disorders\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 2px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 2px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25px;\"\u003e\n \u003cp\u003eHypercalciuria\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e76.27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e30.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e193.81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e31.54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e11.37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e87.49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 2px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 2px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25px;\"\u003e\n \u003cp\u003eCystinuria\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e -\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 2px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 2px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25px;\"\u003e\n \u003cp\u003eDyslipidemia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e3.93\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e2.85\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e5.42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e2.20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e1.47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e3.30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 2px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 2px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25px;\"\u003e\n \u003cp\u003eDiabetes mellitus\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e2.88\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e2.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e4.07\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.52\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e0.99\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e2.36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e0.059\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 2px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"6\" valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eStructural abnormality in the renal system\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 2px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 2px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25px;\"\u003e\n \u003cp\u003eCongenital urinary tract anomaly\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e67.27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e23.59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e191.83\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e22.58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e6.46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e78.88\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 2px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 2px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25px;\"\u003e\n \u003cp\u003eCystic kidney disease\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e9.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e3.86\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e21.43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e8.34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e3.25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e21.35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 2px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 2px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25px;\"\u003e\n \u003cp\u003eVesicoureteral reflux (VUR)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e18.88\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e10.48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e34.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.90\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e0.85\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e4.27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e0.118\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 2px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 2px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25px;\"\u003e\n \u003cp\u003eUreteropelvic junction obstruction (UPJO)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e69.55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e24.48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e197.59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e19.88\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e5.88\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e67.19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 2px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"10\" valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGastrointestinal-related disorders\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 2px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 2px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25px;\"\u003e\n \u003cp\u003eInguinal hernia\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e3.13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.90\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e5.18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.86\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e1.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e3.36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.040\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 2px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 2px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25px;\"\u003e\n \u003cp\u003eInflammatory bowel syndrome\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e2.23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e3.19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.68\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e1.15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e2.45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.008\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 2px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 2px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25px;\"\u003e\n \u003cp\u003eShort-bowel/gut syndrome\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e -\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eOR, odds ratio; CI, confidence interval; aOR, adjusted odds ratio; AEDs, antiepileptic drugs; NSAIDs, non-steroidal anti-inflammatory drug; VUR, vesicoureteral reflux; UPJO, ureteropelvic junction obstruction.\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"583\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 583px;\"\u003e\n \u003cp\u003e Table 4. Surgical and pharmacologic management of pediatric urolithiasis\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" rowspan=\"3\" valign=\"top\" style=\"width: 433px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003ePatients with urolithiasis\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e(n = 10113)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003eN\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 433px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSurgery\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e821\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e8.12\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 433px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTypes of surgery\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 404px;\"\u003e\n \u003cp\u003eUreteroscopy and removal of ureteral stone with SONO/EHL\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e615\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e74.91\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 404px;\"\u003e\n \u003cp\u003eUreteroscopy and removal of ureteral stone with Nd-YAG laser\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e7.06\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 404px;\"\u003e\n \u003cp\u003eUreteroscopy and removal of ureteral stone\u0026mdash;simple endoscopy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e4.87\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 404px;\"\u003e\n \u003cp\u003eUreterolithotomy\u0026mdash;upper or distal 1/3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e0.73\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 404px;\"\u003e\n \u003cp\u003eLaparoscopic ureterolithotomy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e0.24\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 404px;\"\u003e\n \u003cp\u003eCystolithotomy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e1.46\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 404px;\"\u003e\n \u003cp\u003eSimple endoscopic cystolitholapaxy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e3.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 404px;\"\u003e\n \u003cp\u003eComplex endoscopic cystolitholapaxy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e63\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e7.67\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 433px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDrugs used\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 418px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSmooth muscle relaxants\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 404px;\"\u003e\n \u003cp\u003eBuscopan\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e960\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e9.49\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 404px;\"\u003e\n \u003cp\u003eRowapraxin\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e718\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e7.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 418px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eUrinary alkalinizing agents\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 404px;\"\u003e\n \u003cp\u003ePotassium citrate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e657\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e6.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 418px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eA-adrenergic blockers\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 404px;\"\u003e\n \u003cp\u003eTamsulosin\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e379\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e3.75\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 404px;\"\u003e\n \u003cp\u003eTerazosin\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e0.24\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 404px;\"\u003e\n \u003cp\u003eAlfuzosin\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e0.12\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e \u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e \u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 404px;\"\u003e\n \u003cp\u003eDoxazosin\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e96\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e0.95\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 418px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eUric acid-reducing agents\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 404px;\"\u003e\n \u003cp\u003eAllopurinol\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e0.39\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 404px;\"\u003e\n \u003cp\u003eBenzbromarone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e90\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e0.89\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 418px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eThiazides\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e96\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e0.95\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eSONO/EHL, Endoscopic Ultrasonography (SONO) and Electrohydraulic Lithotripsy (EHL)\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":true,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"pediatric-nephrology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pnep","sideBox":"Learn more about [Pediatric Nephrology](http://link.springer.com/journal/467)","snPcode":"467","submissionUrl":"https://www.editorialmanager.com/pnep/default2.aspx","title":"Pediatric Nephrology","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false},"keywords":"pediatric urolithiasis, metabolic risk, chronic kidney disease, cardiovascular complications, nationwide cohort","lastPublishedDoi":"10.21203/rs.3.rs-8075378/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8075378/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e\u003cp\u003ePediatric urolithiasis is increasingly recognized not merely as a localized urinary disorder but as part of a systemic metabolic\u0026ndash;inflammatory process that may predispose to chronic kidney and cardiovascular disease. However, population-based data in Asian pediatric populations with urolithiasis remain limited. This nationwide study investigated the epidemiologic trends, metabolic risk factors, and systemic outcomes associated with pediatric urolithiasis in Taiwan.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e\u003cp\u003eUsing the National Health Insurance Research Database, children newly diagnosed with urolithiasis between January 2009 and December 2018 were identified and matched with controls according to age, sex, and index year. Comorbidities and medication exposures were evaluated, and outcomes including renal, cardiovascular, and metabolic complications were analyzed using Cox proportional hazards models.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eAmong 10,113 affected children and 101,130 matched controls, the annual incidence of pediatric urolithiasis declined from 23.9 to 16.2 per 100,000 persons. A male predominance and peak incidence during adolescence were noted. Major associated factors included hypercalciuria (adjusted hazard ratio [aHR] 31.5), congenital urinary anomalies (aHR 22.6), urinary tract infection (aHR 8.3), and exposure to diuretics or antibiotics. Compared with controls, children with urolithiasis had significantly higher risks of chronic kidney disease (aHR 5.9), hypertension (aHR 1.9), ischemic heart disease (aHR 1.9), and dyslipidemia (aHR 1.8).\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e\u003cp\u003eDespite a modest decline in incidence, pediatric urolithiasis remains a clinically important condition associated with long-term renal and cardiovascular morbidity. These findings highlight the importance of early metabolic evaluation, careful medication stewardship, and continued nephrology follow-up to mitigate chronic sequelae.\u003c/p\u003e","manuscriptTitle":"Nationwide cohort analysis of pediatric urolithiasis: long-term metabolic, renal, and cardiovascular outcomes","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-11-26 06:52:56","doi":"10.21203/rs.3.rs-8075378/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Major Revisions Needed","date":"2025-12-03T09:41:56+00:00","index":"","fulltext":""},{"type":"reviewerAgreed","content":"","date":"2025-11-16T17:10:23+00:00","index":0,"fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-11-13T15:12:47+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-11-13T08:35:53+00:00","index":"","fulltext":""},{"type":"submitted","content":"Pediatric Nephrology","date":"2025-11-10T04:29:13+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"pediatric-nephrology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pnep","sideBox":"Learn more about [Pediatric Nephrology](http://link.springer.com/journal/467)","snPcode":"467","submissionUrl":"https://www.editorialmanager.com/pnep/default2.aspx","title":"Pediatric Nephrology","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false}}],"origin":"","ownerIdentity":"5938fe9e-8635-431a-af6d-f5688d5e58d7","owner":[],"postedDate":"November 26th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2026-03-16T16:01:34+00:00","versionOfRecord":{"articleIdentity":"rs-8075378","link":"https://doi.org/10.1007/s00467-026-07208-7","journal":{"identity":"pediatric-nephrology","isVorOnly":false,"title":"Pediatric Nephrology"},"publishedOn":"2026-03-09 15:58:17","publishedOnDateReadable":"March 9th, 2026"},"versionCreatedAt":"2025-11-26 06:52:56","video":"","vorDoi":"10.1007/s00467-026-07208-7","vorDoiUrl":"https://doi.org/10.1007/s00467-026-07208-7","workflowStages":[]},"version":"v1","identity":"rs-8075378","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8075378","identity":"rs-8075378","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}