Beyond Prevalence: Annual Cumulative Incidence of Kidney Stones in the United States

Abstract

Purpose:It is well documented that the prevalence of nephrolithiasis is increasing in adults in the United States over time. Approximately 11% of men and 7% of women have reported a lifetime history of nephrolithiasis in cross-sectional studies. However, the burden of acute management may be better assessed from annual cumulative incidence. This accounting of new stone occurrences, however, is not well described on a national scale.Materials and Methods:The Medical Expenditure Panel Survey is a set of large-scale health care utilization surveys of families, individuals, their health care providers and employers, with surveys administered every 6 months for the duration of each individual’s 2-year panel. We queried the survey data of adult participants between 2005 and 2015, with analysis conducted with provided weights and strata to allow our findings to be representative of the civilian noninstitutionalized U.S. adult population. Those with diagnosed renal or ureteral calculi as noted by ICD-9 codes were included as our incident stone formers.Results:In 2005, the mean age of stone formers was 45 years. Of stone formers 52.2% were male, 91% were White and 47.6% were in the Southern U.S. The incidence of stone occurrences was 0.6% (177/33,961 individuals, weighted to represent population of 1,923,322/296,185,002 individuals). By 2015, the mean age was 51.7 years, with 52% male, 83% White and 38.2% residing in the Southern U.S. Between 2005 and 2015, the overall incidence increased from 0.6% to 0.9% (p <0.001).Conclusions:Based on this large-scale, nationally representative analysis of adults in the United States, the estimated annual cumulative incidence of stone occurrence is approaching 1%. Moreover, this incidence appears to be increasing over time, rising from 0.6% in 2005 to 0.9% in 2015. These data may help to better anticipate the need for urological care for stone disease and direct resource distribution.

Incidence of Kidney Stones in the United States: The Continuous National Health and Nutrition Examination Survey

“…Similar to our study, the work of Tundo et al, with data up to 2015, is also in theory representative of the entire United States population. 9 We made use of NHANES, while they utilized the Medical Expenditure Panel Survey. Both of these questionnaires survey households and attempt to generalize findings to the larger population.…”

Prevalence and trends of urolithiasis among adults

“…Yet, the temporal trends in the prevalence of kidney stone in the United States population were stable across age groups among men from 2007 to 2018 [6 ▪▪ ]. In a nationally representative study that assessed the annual incidence of kidney stones in the United States, the mean age of stone formers has significantly increased from 45 years in 2005 to 51.7 years in 2015 [18 ▪ ]. Similarly, in northern Italy, the average age of patients was significantly lower in the 2001–2003 group (45.8 years) than in the 2016–2018 group (57.9 years) [24].…”

The Economic Burden of Cystoscopy-Based Ureteral Stent Removal in the United States: An Analysis of Nearly 30,000 Patients

“…This study had several strengths and adds a meaningful understanding of the CBSR usage pattern among practitioners in the U.S. Our study is the first to examine the incidence and economic burden of CBSR using a nationally representative sample of U.S. workers younger than 65 years old. Given that kidney stone is prevalent in younger adults, 14 this study provides clinical and economic evidence that could help inform the selection of ureteral stents in practice among the population likely to suffer from the condition. Our work also serves to better understand and develop strategies to reduce these costs as there is an increasing incidence of kidney stone in recent years.…”