Advertisement
Platinum Priority – Stone Disease Editorial by Brian R. Matlaga on pp. 166–167 of this issue| Volume 62, ISSUE 1, P160-165, July 01, 2012

Prevalence of Kidney Stones in the United States

      Abstract

      Background

      The last nationally representative assessment of kidney stone prevalence in the United States occurred in 1994. After a 13-yr hiatus, the National Health and Nutrition Examination Survey (NHANES) reinitiated data collection regarding kidney stone history.

      Objective

      Describe the current prevalence of stone disease in the United States, and identify factors associated with a history of kidney stones.

      Design, setting, and participants

      A cross-sectional analysis of responses to the 2007–2010 NHANES (n = 12 110).

      Outcome measurements and statistical analysis

      Self-reported history of kidney stones. Percent prevalence was calculated and multivariable models were used to identify factors associated with a history of kidney stones.

      Results and limitations

      The prevalence of kidney stones was 8.8% (95% confidence interval [CI], 8.1–9.5). Among men, the prevalence of stones was 10.6% (95% CI, 9.4–11.9), compared with 7.1% (95% CI, 6.4–7.8) among women. Kidney stones were more common among obese than normal-weight individuals (11.2% [95% CI, 10.0–12.3] compared with 6.1% [95% CI, 4.8–7.4], respectively; p < 0.001). Black, non-Hispanic and Hispanic individuals were less likely to report a history of stone disease than were white, non-Hispanic individuals (black, non-Hispanic: odds ratio [OR]: 0.37 [95% CI, 0.28–0.49], p < 0.001; Hispanic: OR: 0.60 [95% CI, 0.49–0.73], p < 0.001). Obesity and diabetes were strongly associated with a history of kidney stones in multivariable models. The cross-sectional survey design limits causal inference regarding potential risk factors for kidney stones.

      Conclusions

      Kidney stones affect approximately 1 in 11 people in the United States. These data represent a marked increase in stone disease compared with the NHANES III cohort, particularly in black, non-Hispanic and Hispanic individuals. Diet and lifestyle factors likely play an important role in the changing epidemiology of kidney stones.

      Keywords

      To read this article in full you will need to make a payment

      Subscribe:

      Subscribe to European Urology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Stamatelou K.K.
        • Francis M.E.
        • Jones C.A.
        • Nyberg L.M.
        • Curhan G.C.
        Time trends in reported prevalence of kidney stones in the United States: 1976–1994.
        Kidney Int. 2003; 63: 1817-1823
        • Pearle M.S.
        • Calhoun E.A.
        • Curhan G.C.
        Urologic Diseases in America project: urolithiasis.
        J Urol. 2005; 173: 848-857
        • Scales Jr., C.D.
        • Curtis L.H.
        • Norris R.D.
        • et al.
        Changing gender prevalence of stone disease.
        J Urol. 2007; 177: 979-982
        • Taylor E.N.
        • Stampfer M.J.
        • Curhan G.C.
        Obesity, weight gain, and the risk of kidney stones.
        JAMA. 2005; 293: 455-462
        • Taylor E.N.
        • Stampfer M.J.
        • Curhan G.C.
        Diabetes mellitus and the risk of nephrolithiasis.
        Kidney Int. 2005; 68: 1230-1235
        • Hedley A.A.
        • Ogden C.L.
        • Johnson C.L.
        • Carroll M.D.
        • Curtin L.R.
        • Flegal K.M.
        Prevalence of overweight and obesity among US children, adolescents, and adults, 1999–2002.
        JAMA. 2004; 291: 2847-2850
      1. Analytic note regarding 2007–2010 survey design changes and combining data across other survey cycles. US Centers for Disease Control and Prevention Web site. http://www.cdc.gov/nchs/data/nhanes/analyticnote_2007-2010.pdf.

        • Ekeruo W.O.
        • Tan Y.H.
        • Young M.D.
        • et al.
        Metabolic risk factors and the impact of medical therapy on the management of nephrolithiasis in obese patients.
        J Urol. 2004; 172: 159-163
        • Maalouf N.M.
        • Sakhaee K.
        • Parks J.H.
        • Coe F.L.
        • Adams-Huet B.
        • Pak C.Y.
        Association of urinary pH with body weight in nephrolithiasis.
        Kidney Int. 2004; 65: 1422-1425
        • Powell C.R.
        • Stoller M.L.
        • Schwartz B.F.
        • et al.
        Impact of body weight on urinary electrolytes in urinary stone formers.
        Urology. 2000; 55: 825-830
        • Rumenapf G.
        • Schmidtler J.
        • Schwille P.O.
        Intestinal calcium absorption during hyperinsulinemic euglycemic glucose clamp in healthy humans.
        Calcif Tissue Int. 1990; 46: 73-79
        • Kerstetter J.
        • Caballero B.
        • O’Brien K.
        • Wurtman R.
        • Allen L.
        Mineral homeostasis in obesity: effects of euglycemic hyperinsulinemia.
        Metabolism. 1991; 40: 707-713
        • Abate N.
        • Chandalia M.
        • Cabo-Chan Jr., A.V.
        • Moe O.W.
        • Sakhaee K.
        The metabolic syndrome and uric acid nephrolithiasis: novel features of renal manifestation of insulin resistance.
        Kidney Int. 2004; 65: 386-392
        • Flegal K.M.
        • Carroll M.D.
        • Ogden C.L.
        • Curtin L.R.
        Prevalence and trends in obesity among US adults, 1999–2008.
        JAMA. 2010; 303: 235-241
        • Soucie J.M.
        • Coates R.J.
        • McClellan W.
        • Austin H.
        • Thun M.
        Relation between geographic variability in kidney stones prevalence and risk factors for stones.
        Am J Epidemiol. 1996; 143: 487-495
        • Chen Y.Y.
        • Roseman J.M.
        • Devivo M.J.
        • Huang C.T.
        Geographic variation and environmental risk factors for the incidence of initial kidney stones in patients with spinal cord injury.
        J Urol. 2000; 164: 21-26
        • Clark J.Y.
        Renal calculi in army aviators.
        Aviat Space Environ Med. 1990; 61: 744-747
        • Cramer J.S.
        • Forrest K.
        Renal lithiasis: addressing the risks of austere desert deployments.
        Aviat Space Environ Med. 2006; 77: 649-653
        • Pierce L.W.
        • Bloom B.
        Observations on urolithiasis among American troops in a desert area.
        J Urol. 1945; 54: 466-470
        • Evans K.
        • Costabile R.A.
        Time to development of symptomatic urinary calculi in a high risk environment.
        J Urol. 2005; 173: 858-861
        • Brikowski T.H.
        • Lotan Y.
        • Pearle M.S.
        Climate-related increase in the prevalence of urolithiasis in the United States.
        Proc Natl Acad Sci U S A. 2008; 105: 9841-9846
      2. Litwin MS, Saigal CS. Introduction. In: Litwin MS, Saigal CS, editors. Urologic Diseases in America. Washington, DC: US Department of Health and Human Services, Public Health Service, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases; 2007.

        • Saigal C.S.
        • Joyce G.
        • Timilsina A.R.
        Direct and indirect costs of nephrolithiasis in an employed population: opportunity for disease management?.
        Kidney Int. 2005; 68: 1808-1814
        • Pearle M.S.
        • Roehrborn C.G.
        • Pak C.Y.
        Meta-analysis of randomized trials for medical prevention of calcium oxalate nephrolithiasis.
        J Endourol. 1999; 13: 679-685
        • Escribano J.
        • Balaguer A.
        • Pagone F.
        • Feliu A.
        • Roque I.F.M.
        Pharmacological interventions for preventing complications in idiopathic hypercalciuria.
        Cochrane Database Syst Rev. 2009; : CD004754
        • Fink H.A.
        • Akornor J.W.
        • Garimella P.S.
        • et al.
        Diet, fluid, or supplements for secondary prevention of nephrolithiasis: a systematic review and meta-analysis of randomized trials.
        Eur Urol. 2009; 56: 72-80
        • Qiang W.
        • Ke Z.
        Water for preventing urinary calculi.
        Cochrane Database Syst Rev. 2004; : CD004292

      Linked Article