Kidney stones: a global picture of prevalence, incidence, and associated risk factors

Abstract

The prevalence and incidence of nephrolithiasis is reported to be increasing across the world. Herein, we review information regarding stone incidence and prevalence from a global perspective. A literature search using PubMed and Ovid was performed to identify peer-reviewed journal articles containing information on the incidence and prevalence of kidney stones. Key words used included kidney stone prevalence, incidence, and epidemiology. Data were collected from the identified literature and sorted by demographic factors and time period. A total of 75 articles were identified containing kidney stone-related incidence or prevalence data from 20 countries; 34 provided suitable information for review. Data regarding overall prevalence or incidence for more than a single time period were found for 7 countries (incidence data for 4 countries; prevalence data for 5 countries). These included 5 European countries (Italy, Germany, Scotland, Spain, and Sweden), Japan, and the United States. The body of evidence suggests that the incidence and prevalence of kidney stones is increasing globally. These increases are seen across sex, race, and age. Changes in dietary practices may be a key driving force. In addition, global warming may influence these trends.

Keywords: Epidemiology; Kidney stones; Nephrolithiasis; Stone incidence.

Figure 1

2005 Iran kidney stone incidence by age group. A rise-and-fall pattern is observed for reported incidence rates in Iran during 2005. Peak incidence is observed in the 40- to 49-year-old age group.

Figure 2

Japan kidney stone incidence by age group. Incidence data reported for Japanese men (A) and women (B) show a consistent rise-and-fall pattern in every year of reporting. Male peak incidence occurs between ages 40 and 49 years, whereas female peak incidence occurs between ages 50 and 59 years. One can also observe an increase in incidence over time in both men and women.

Figure 3

1986 United States kidney stone incidence by age group. A rise-and-fall pattern is observed for reported incidence rates in the United States during 1986. Peak incidence is observed between ages 45 and 49 years.

Figure 4

Germany kidney stone prevalence by age group. An increasing prevalence is observed for Germans as they age. This trend is observed in both 1979 and 2001.

Figure 5

1996 Iceland kidney stone prevalence by age group. An increasing prevalence is observed in Iceland as the population ages. This trend is observed in both men and women.

Figure 6

2005 Iran kidney stone prevalence by age group. Prevalence increases with increasing age among Iran’s population up until age 50 to 59 years, after which it remains stable.

Figure 7

1993 Italian kidney stone prevalence by age group. An increasing prevalence with increasing age is observed in Italy for both men and women.

Figure 8

2006 Thebes, Greece, kidney stone prevalence by age group. An increasing prevalence is observed with increasing age among those living in Thebes for both men and women.

Figure 9

1989 Turkey kidney stone prevalence by age group. An increasing prevalence of kidney stones is observed as the population ages.

Figure 10

US kidney stone prevalence by age group. In 1978, prevalence in US men and women demonstrates a rise-and-fall pattern as the population ages, with peak prevalence occurring between age 60 and 69 years in men, and between age 50 and 59 in women. In 1991, prevalence continues increasing with advancing age in men, although remaining stable in women age > 59 years.

Figure 11

Milan, Italy, kidney stone prevalence by age group. An increasing prevalence is observed with increasing age among those living in Milan, but a prevalence decrease occurs after age > 60 years.

Figure 12

1998 Korea kidney stone prevalence by age group. Korean men demonstrated a decrease in stone prevalence with increasing age. Korean women demonstrated a rise-and-fall pattern, with peak incidence occurring between age 60 and 69 years.

Figure 13

US kidney stone prevalence rates by race. Data for kidney stone prevalence rates show rates being lowest in Asian women (A) and highest in white men (B). CPS, Cancer Prevention Study; NHANES, National Health and Nutrition Examination Survey.

Figure 14

US kidney stone prevalence by race and age group. An increasing prevalence with increasing age is observed in US white and black men for both reporting periods. Prevalence has nearly doubled for black men in the 60- to 74-year-old age group between the 2 time periods.