Epidemiology of urolithiasis in the elderly

Abstract

To estimate the epidemiology of upper urinary stones in the elderly, a total of 1,957 patients (1,349 men and 608 women) with urolithiasis were studied. The ratio of men to women was approximately 3:1 in middle-aged (between 30 and 59 years), 1:1 in young (29 or younger) and 1:1 in old patients (60 or older). Compared with the age distribution of the entire Japanese population, the incidence of urinary stones was very low in both male and female children, twice as high in middle-aged men, slightly higher in middle-aged women, and equal or slightly lower in the male and female elderly. Stones of calcium oxalate and uric acid occurred more frequently and those of calcium phosphate and struvite less frequently in men than in women. This tendency was especially obvious in the middle-aged. In the old generation, calcium oxalate stones occurred almost equally in men and women. Results of urinary stone analysis were similar among men of the three generations, although the incidence of uric acid stones increased with patient age. In women, however, the incidence of calcium oxalate was higher in the young and old generations, while that of calcium phosphate was higher in the middle-aged.

Comparison of Metabolic Risk Factors in Patients with Recurrent Urolithiasis Stratified according to Age and Gender

“…Few studies which have investigated urine from normal subjects have not reported any significant differences in urinary constituents between the young and old population [21]. Therefore, though we did not analyze the urine from subjects without a history of stone disease in this study, the results are considered to be reliable for comparison of metabolic characteristics between young and old generations.…”

The liver and kidney expression of sulfate anion transporter sat-1 in rats exhibits male-dominant gender differences

“…The male-dominant gender differences in the urine oxalate excretion and incidence of oxalate stones have also been observed in adult but not in young and old human patients [7-9, 22, 26, 48], thus indicating that sex hormones could be an important contributor to gender-dependent incidence of this disease in adult humans [22]. However, possible differences in the expression of sat-1 in liver and kidneys, as well as the correlation with the plasma and urine oxalate in humans, to our knowledge have not been reported.…”

“…Men exhibit higher oxalate excretion levels than women [26], as well as higher incidence of oxalate stones [7]; the incidence is two to threefold higher in male patients in middle age (30-59 years) but similar in both genders in young and old patients [7,8,22,48]. Furthermore, in a few studies of experimental nephrolithiasis in rats treated with ethylene glycol, testosterone stimulated, whereas female sex hormones inhibited, urine excretion of oxalate and formation of oxalate stones [15,25].…”

Oxalate: From the Environment to Kidney Stones

“…The frequency of CaOx urolithiasis in the middle aged population is 2 to 3 times higher in men than in women, whereas in the young and elderly population, this male-dominant prevalence is absent (161)(162)(163). The male-dominant urolithiasis was initially associated with greater body mass and body surface area, which are positively correlated with higher rates of urine oxalate, Ca…”