Emma Hitt, PhD

May 24, 2012

May 24, 2012 (Atlanta, Georgia) — The burgeoning obesity epidemic might be linked to yet another health problem; there has been a near doubling in the incidence of kidney stones since a previous analysis conducted in 1994, according to research presented in a podium session here at the American Urological Association 2012 Annual Scientific Meeting.

The study results were also published online March 31 in European Urology.

"While we expected the prevalence of kidney stones to increase, the size of the increase was surprising," said Charles D. Scales Jr., MD, from the Departments of Urology and Medicine at the David Geffen School of Medicine at the University of California at Los Angeles (UCLA). "Our findings also suggest that the increase is due, in large part, to the increase in obesity and diabetes among Americans."

Dr. Scales and colleagues compared data from the National Health and Nutrition Examination Survey (NHANES) collected from 2007 to 2010 with data from the 1994 NHANES. In responses collected from 2007 to 2010, 1 in every 11 people reported that they had had a kidney stone; in 1994, the rate was much lower (1 in 20).

Among 5935 NHANES respondents, the overall prevalence of stone disease was 8.9% (95% confidence interval [CI], 7.7 to 10.2). In men, the overall prevalence was 11.4% (95% CI, 9.5 to 13.3); in women, it was 6.4% (95% CI, 5.3 to 7.6; P < .001). In men, the prevalence ranged from 3.0% (95% CI, 1.2 to 4.7) in people 20 to 29 years of age, to 20.5% (95% CI, 16.6 to 24.4) in those 60 to 69 years of age.

"This represents a dramatic 71% increase in the prevalence of stone disease since the last assessment, and this increase occurred in all gender and racial/ethnic groups," Dr. Scales and colleagues conclude in their abstract. "These data suggest that the burden of disease from kidney stones will continue to rise in the United States."

"People should consider the increased risk of kidney stones as another reason to maintain a healthy lifestyle and body weight," noted Christopher S. Saigal, MD, MPH, senior author of the study, and associate professor of urology at the David Geffen School of Medicine at UCLA, in a written release. "Physicians need to rethink how to treat, and more importantly, prevent kidney stones."

Dr. Scales noted that helping patients maintain a healthy diet and body weight can reduce the number of patients with kidney stones. "Imagine that we only treated people with heart disease when they had chest pain or heart attacks, and did not help manage risk factors like smoking, high cholesterol, and high blood pressure," he said. "This is how we currently treat people with kidney stones."

In a related editorial, published online April 20 in European Urology, Brian Matlaga, MD, MPH, associate professor of urology at the Johns Hopkins University School of Medicine in Baltimore, Maryland, writes that the cost of care for this disease is enormous, and there is no indication that the coming years will see any improvement in this trend. He also warns that, since approximately 10% of the population has the disease, a greater emphasis on prevention is imperative.

The study was not commercially funded. Dr. Scales and Dr. Matlaga have disclosed no relevant financial relationships.

Eur Urol. Published online March 31 and April 20, 2012. Abstract, Editorial

American Urological Association (AUA) 2012 Annual Scientific Meeting: Abstract 52. Presented May 19, 2012.

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