CHOP Kidney Stone Center Research Overview

The CHOP Kidney Stone Center Frontier Program focuses on the translational, epidemiologic, and patient-oriented investigation of kidney stone disease. Investigators collect stool, urine, and saliva samples from a large cohort of children and adults with kidney stones and healthy controls to contribute to multi-omic discovery work and a longitudinal biorepository for future research. They will leverage these samples to develop new diagnostic tests using spot urine samples. The transformation from collecting 24 hours of urine to one that can be collected in less than a minute will introduce a new era of personalized kidney stone management.

Better Understanding Kidney Stone Disease

Researchers in the CHOP Kidney Stone Center have published more than 120 articles on pediatric nephrolithiasis since 2014. They were the first to describe the impact of high daily temperatures on kidney stone presentations, a finding that climate change makes increasingly important. They also published the first evidence that antibiotics are associated with an increased risk of kidney stones and that the risk is greatest for those exposed at younger ages. These results could help explain the rapid increase in the incidence of pediatric nephrolithiasis that they reported in 2016.

They also discovered a bacterial network that produces butyrate and degrades oxalate is less abundant in children with calcium oxalate kidney stones. These results opened new investigations to discover medications that affect butyrate and oxalate metabolism and led to NIH funding to investigate the gut-kidney axis in kidney stone disease across the lifespan. With this support, they are collecting 300 stool, urine, and saliva samples from children and adults with calcium kidney stones and matched controls.

A Collaborative National Research Network

The Center also leads clinical research networks founded on learning health system principles that have expanded the research program throughout North America. Dr. Tasian founded the Pediatric KIDney Stone Care Improvement Network (PKIDS) in 2018. This community of patients, caregivers, clinicians, and researchers collaborate to improve outcomes for children with kidney stones in 30 U.S. and Canadian health systems. In July 2023, PKIDS completed enrollment of 1,291 patients in a PCORI-funded comparative effectiveness trial of surgical interventions for children with kidney and ureteral stones. Using learning health system methods, PKIDS investigators are integrating the knowledge generated by this trial directly into clinical care to improve patient outcomes. The Frontier Program will enable CHOP investigators to leverage the regulatory framework and relationships in PKIDS to enhance a Data Integration Hub that will support multicenter clinical trials of the new diagnostic tests and novel therapeutics developed through our multi-omics research program.