Use of the National Health and Nutrition Examination Survey to Calculate the Impact of Obesity and Diabetes on Cost and Prevalence of Urolithiasis in 2030

Abstract

Background The prevalence of urolithiasis and its risk factors such as obesity and diabetes have increased over time. Objective Determine the future cost and prevalence of kidney stones using current and projected estimates for stones, obesity, diabetes, gender, and population rates. Design, Setting, and participants The Stone prevalence in 2000 was estimated from National Health and Nutrition Examination Survey (NHANES) 1988–1994 and 2007–2010. The cost per percent prevalence of stone disease in 2000, calculated using Urologic Diseases in America Project data, was used to estimate the annual cost of stones in 2030, adjusting for inflation and increases in population, stone prevalence, obesity, and diabetes rates. Outcome measurements and statistical analysis The primary outcome was prevalence and cost of stones in 2030. The secondary outcomes were the impact of obesity and diabetes on these values, calculated using ratios for stones by body mass index and diabetes status. Results and limitations The annual cost of stone disease in 2000, adjusted for inflation to 2014 US dollars, was approximately $2.81 billion. After accounting for increased in population and stone prevalence from 2000, the estimated cost of stones in 2007 in 2014 US dollars was $3.79 billion. Future population growth alone would increase the cost of stone disease by $780 million in 2030. Based on projected estimates for 2030, obesity will independently increase stone prevalence by 0.36%, with an annual cost increase of $157 million. Diabetes will independently increase stone prevalence by 0.72, associated with a cost increase of $308 million annually by 2030. NHANES data, however, capture patient self-assessment rather than medical diagnosis, which is a potential bias. Conclusions The rising prevalence of obesity and diabetes, together with population growth, is projected to contribute to dramatic increases in the cost of urolithiasis, with an additional $1.24 billion/yr estimated by 2030. Patient Summary Obesity, diabetes, and population rates will contribute to an estimated $1.24 billion/yr increases in the cost of kidney stones by 2030.

Compliance of the recurrent renal stone former with current best practice guidelines

“…5 The rising incidence in associated medical comorbidities including both obesity and diabetes is expected to result in an increased stone management cost of $1.24 billion dollars yearly in the United States by 2030. 19 Increasing patient awareness and knowledge of preventative stone practices would improve both patient outcomes while concurrently The majority of participants demonstrated confidence in the utility of preventative practices in stone prevention. Despite this confidence, compliance rates were marginal.…”

<i>Glechoma longituba</i> (Lamiaceae) alleviates apoptosis in calcium oxalate-induced oxidative stress in kidney proximal tubule epithelial cell line, HK-2

“…In addition, the incidence of nephrolithiasis among adolescents has also increased by 6-10% annually [3,4]. The increase of nephrolithiasis is a challenge to human health, and an economic burden for families and society [5]. Currently, surgery and medical treatments are the main therapies for nephrolithiasis, but the outcome remains unsatisfactory.…”

Metabolic evaluation guidelines in patients with nephrolithiasis: Are they being followed? Results of a national, multi-institutional, quality-assessment study

“…[5][6][7][8] Moreover, the increasing prevalence of metabolic diseases such as obesity and diabetes and their association with stone disease are expected to increase the incidence of kidney stone disease and contribute to increasing the cost burden by 1.24 billion dollars per year by 2030. [9,10] Similarly, the incidence of stone compositions related to dietary and metabolic risk factors, such as uric acid stones, is also believed to be increasing according to recent evidence. [9] Given the chronic nature of urolithiasis and the rising costs to the health care system, prevention of stone recurrence is important and highlights the potential value of following clinical practice guidelines in kidney stones management.…”

“…[9,10] Similarly, the incidence of stone compositions related to dietary and metabolic risk factors, such as uric acid stones, is also believed to be increasing according to recent evidence. [9] Given the chronic nature of urolithiasis and the rising costs to the health care system, prevention of stone recurrence is important and highlights the potential value of following clinical practice guidelines in kidney stones management. Diet and lifestyle factors play a central role in kidney stone prevention and have the potential to slow down the epidemic of stone disease.…”