Pediatric urolithiasis is a common urological condition associated with significant morbidity in children, posing substantial health challenges globally. It affects millions of children globally, with significant variation in burden across regions and socioeconomic contexts. Understanding pediatric urolithiasis trends is essential for formulating effective policies to manage and prevent this surgically treatable non-communicable disease in children.

This study utilized data from the Global Burden of Disease (GBD) Study 2021 to assess the incidence, mortality, and disability-adjusted life years (DALYs) of pediatric urolithiasis from 1990 to 2021. Data were stratified into four pediatric age groups and analyzed globally and regionally using R (version 4.2.3) for visualization. Temporal trends were assessed using Joinpoint regression analysis, with Estimated Annual Percentage Changes (EAPCs) calculated to identify significant changes over time. The relationship between the Socio-Demographic Index (SDI) and disease burden was analyzed by stratifying results into SDI categories. All metrics were presented with 95% uncertainty intervals, adhering to STROBE guidelines.

Globally, pediatric urolithiasis cases rose from 1,355,160 in 1990 to 1,562,095 in 2021, although the incidence rate remained stable (EAPC: -0.18). Mortality decreased significantly, with deaths dropping from 180 in 1990 to 76 in 2021 (EAPC: -2.82). DALYs also declined from 18,975 in 1990 to 10,773 in 2021 (EAPC: -2.22). The burden varied by SDI regions, with low SDI regions showing increasing incidence and high SDI regions experiencing declines. East Asia showed the greatest reductions in mortality and DALYs, whereas South Asia and Western Sub-Saharan Africa exhibited increasing trends. Nationally, countries such as China and Georgia exhibited significant reductions in incidence, mortality, and DALYs, whereas Spain and Ecuador showed increasing incidence rates.

While the global burden of pediatric urolithiasis has decreased in mortality and DALYs, rising incidence in low-SDI regions underscores the need for equitable healthcare policies and enhanced preventive measures.