Determinants of pediatric urolithiasis hospitalizations in endemic and non-endemic regions of Mexico

BackgroundUrolithiasis in pediatric populations is increasing worldwide, with environmental and social determinants playing key roles. In Mexico, Yucatan is an endemic area for urolithiasis in adults. However, pediatric data are scarce.ObjectiveThis study aimed to describe the clinical and ecological characteristics of pediatric urolithiasis hospitalizations in endemic (Yucatan) and non-endemic areas of Mexico.MethodsWe conducted a retrospective, cross-sectional analysis of national hospital discharge records (2018–2024) for patients <18 years with ICD-10 codes N20.0, N20.1, N20.9, N21.0, and N21.1. The sociodemographic and clinical variables were compared between Yucatan and other states. Non-parametric regression models were used to examine the associations between ecological indicators and hospitalization rates.ResultsA total of 2,238 hospitalizations were identified, with a national rate of 3.28 per 10,000 versus 28.03 in Yucatan. Patients in Yucatan were younger (mean = 111 vs. 128 months, p < 0.001) and more likely to self-report as indigenous (4.9% vs. 2.3%, p = 0.01). The majority of admissions originated from the emergency department (76% vs. 64%, p < 0.001). In the adjusted models, poverty was positively associated with hospitalization rates (β = 0.06, p = 0.032), while water hardness and marginalization lost significance.ConclusionPediatric urolithiasis in Yucatan is associated with younger age, indigenous status, and higher hospitalization rates, highlighting the combined role of environmental and socioeconomic factors. Poverty emerged as a key determinant, underscoring the need for targeted preventive strategies, improved access to safe hydration, and culturally sensitive interventions in vulnerable populations.