Clinical Investigation

Kidney International (1994) 46, 893–899; doi:10.1038/ki.1994.347

Demographic and geographic variability of kidney stones in the United States

J Michael Soucie, Michael J Thun, Ralph J Coates, William McClellan and Harland Austin

Department of Family and Preventive Medicine, Emory University School of Medicine; Department of Epidemiology & Statistics, American Cancer Society; Division of Epidemiology, School of Public Health, and Renal Division, Emory University School of Medicine, Atlanta, Georgia, USA

Correspondence: J Michael Soucie MPH, Department of Family and Preventive Medicine, Emory University School of Medicine, Steiner Building Room 220, 69 Butler St. SE, Atlanta, Georgia 30303, USA.

Received 24 January 1994; Revised 11 April 1994; Accepted 11 April 1994.

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Abstract

Demographic and geographic variability of kidney stones in the United States. To characterize demographic and regional variation in kidney stone prevalence in the U.S., we studied two nationwide cross-sectional surveys that included data on self-reported, physician-diagnosed kidney stones, supplementing published data on hospitalizations for stones. The larger study, Cancer Prevention Study II (CPS II), included 1,185,124 men and women, age greater than or equal to30, recruited nationally in 1982, and provides state-specific prevalence estimates. The National Health and Nutrition Examination Survey (NHANES II) was a national probability sample of 25,286 U.S. adults interviewed between 1976 and 1980. Kidney stone prevalence increased with age until age 70, then declined and was higher in men than women and in whites than blacks. Prevalence among Hispanic and Asian men was intermediate between that of whites and blacks. There was a strong, statistically significant regional variability in stone prevalence among U.S. whites. The age-adjusted prevalence increased from north to south, and from west to east. The contrast in state-specific prevalence was greatest between men in North Carolina (prevalence = 14.9; 95% confidence interval = 14.2 to 15.7) and North Dakota (5.6; 4.7 to 6.4), and between women in South Carolina (6.4; 5.8 to 6.9) and South Dakota (2.4; 1.9 to 2.9). The marked variations in kidney stone prevalence by age, gender, race, and geographic location may provide clues to their etiology and prevention.

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References

  1. Johnson CM, Wilson DM, O'Fallon WM, Malek RS, Kurland LT: Renal stone epidemiology: A 25 year study in Rochester, Minnesota. Kidney Int 16:624–631, 1979 | PubMed | ISI | ChemPort |
  2. Sarmina I, Spirnak JP, Resnick MI: Urinary lithiasis in the black population: An epidemiological study and review of the literature. J Urol 138:14–17, 1987 | PubMed | ISI | ChemPort |
  3. Hiatt RA, Dales LG, Friedman GD, Hunkeler EM: Frequency of urolithiasis in a prepaid medical care program. Am J Epidemiol 115:255–265, 1982 | PubMed | ISI | ChemPort |
  4. Boyce WH, Garvey FK, Strawcutter HE: Incidence of urinary calculi among patients in general hospitals, 1948 to 1952. JAMA 161:1437–1442, 1956 | ISI | ChemPort |
  5. Sierakowski R, Finlayson B, Landes RR, Finlayson CD, Sierakowski N: The frequency of urolithiasis in hospital discharge diagnosis in the United States. Invest Urol 15:438–441, 1978 | PubMed | ISI | ChemPort |
  6. Schey HM, Corbett WT, Resnick MI: Prevalence rate of renal stone disease in Forsyth County, North Carolina during 1977. J Urol 122:288–291, 1979 | PubMed | ISI | ChemPort |
  7. Thun MJ, Schober S: Urolithiasis in Tennessee: An occupational window into a regional problem. Am J Public Health 81:587–591 1991
  8. Stellman SD, Garfinkel L: Smoking habits and tar levels in a new American Cancer Society prospective study of 1.2 million men and women. J Natl Cancer Inst 76:1057–1063, 1986
  9. Koopmans LH: An Introduction to Contemporary Statistics. Boston, Duxbury Press, 1981, p 213
  10. Kleinbaum DG, Kupper LL, Morgenstern H: Epidemiologic Research. New York, Van Nostrand Reinhold, 1982, p 147
  11. Pierce LW, Bloom B: Observations on urolithiasis among American troops in a desert area. J Urol 54:466–470, 1945
  12. Prince CL, Scardino PL, Wolan CT: The effect of temperature, humidity and dehydration on the formation of renal calculi. J Urol 75:209–214, 1956
  13. Prince CL, Scardino PL: Statistical analysis of ureteric calculi. J Urol 83:561–565, 1960
  14. Leonard RH: Quantitative composition of kidney stones. Clin Chem 7:546–551, 1961
  15. Bateson EM: Renal tract calculi and climate. Med J Aust ii:111–113, 1973
  16. Robertson WG, Peacock M, Marshall RW, Speed R, Nordin BE: Seasonal variations in the composition of urine in relation to calcium stone-formation. Clin Sci Mol Med 49:597–602, 1975
  17. Fujita K: Epidemiology of urinary stone colic. Eur Urol 5:26–28, 1979
  18. Frank M, DeVries A, Lazebnik J, Kochwa S: Epidemiological investigation of urolithiasis in Israel. J Urol 81:497–504, 1959
  19. Blacklock NJ: The pattern of urolithiasis in the Royal Navy, in Proceedings of the Renal Stone Research Symposium, Leeds 1968, edited by Hodgkinson A, Nordin BEC, London, J. & A. Churchill Ltd, 1969, pp 38–48
  20. Frank M, DeVries A: Prevention of urolithiasis. Arch Environ Health 13:625–630, 1966
  21. Parry ES, Lister IS: Sunlight and hypercalciuria. Lancet 1:1063–1065, 1975 | PubMed | ISI | ChemPort |
  22. Berlin T, Holmberg I, Bjorkhem I: High circulating levels of 25-hydroxyvitamin D3 in renal stone formers with hyperabsorptive hypercalciuria. Scand J Clin Lab Invest 46:367–374, 1986 | PubMed |
  23. Giannini S, Nobile M, Castrignano R, Pati T, Tasca A, Villi G, Pellegrini F, D'Angelo A: Possible link between vitamin D and hyperoxaluria in patients with renal stone disease. Clin Sci 84:51–54, 1993
  24. Curhan GC, Willett WC, Rimm EB, Stampfer MJ: A prospective study of dietary calcium and other nutrients and the risk of symptomatic kidney stones. N Engl J Med 328:833–838, 1993 | Article | PubMed | ISI | ChemPort |
  25. Shuster J, Finlayson B, Scheaffer R, Sierakowski R, Zoltek J, Dzegede S: Water hardness and urinary stone disease. J Urol 128:422–425, 1982 | PubMed | ISI | ChemPort |
  26. Cappuccio FP, Stazzullo P, Mancini M: Kidney stones and hypertension: population based study of an independent clinical association. Br Med J 300:1234–1236, 1990 | ISI | ChemPort |
  27. Ulmann A, Aubert J, Bourdeau A, Cheynel C, Bader C: Effects of weight and glucose ingestion on urinary calcium and phosphate excretion: Implications for calcium urolithiasis. J Clin Endocrinol Metab 54:1063–1068, 1982
  28. Powis SJA, Black J, Macdougall JA, Clews JW: Management of patients with urinary calculi. Br Med J i:355–357, 1974
  29. Hedenberg I: Renal and ureteral calculi, a study of the occurrence in Sweden 1911–1938 with some notes on the geographical distribution. Acta Chir Scand 101:17–36, 1951
  30. Norlin A, Lindell B, Granberg P, Lindvall N: Urolithiasis: A study of its frequency. Scand J Urol Nephrol 10:150–153, 1976 | PubMed | ISI | ChemPort |
  31. Andersen DA: Historical and geographical differences in the pattern of incidence of urinary stones considered in relation to possible aetiological factors, in Proceedings of the Renal Stone Research Symposium, Leeds 1968, edited by Hodgkinson A, Nordin BEC, London, J. & A. Churchill Ltd, 1969, pp 7–32
  32. Wise RO, Kark AE: Urinary calculi and serum calcium levels in Africans and Indians. S Afr Med J 35:47–50, 1961
  33. Walker ARP, Arvidsson UB, Politzer WM: Significance of low serum calcium values in South African Bantu. S Afr Med J 28:48–51, 1954
  34. Walker ARP: Some aspects of nutritional research in South Africa. Nutr Rev 14:321–324, 1956
  35. Vermooten V: The occurrence of renal calculi and their possible relation to diet. JAMA 109:857–859, 1937
  36. Muskat DA: Problem of nephrolithiasis, with special reference to Bantu. S Afr J Clin Sci 2:18–37, 1951
  37. Modlin M, Davies PJ, Crawford D: Dietary structure and urinary composition in a stone-free population, in Urolithiasis: Clinical and Basic Research, edited by Smith LH, Robertson WG, Finlayson B, New York, Plenum Press, 1981, pp 337–342
  38. Esho JO: The rarity of urinary calculus in Nigeria. Trop Geogr Med 30:477–481, 1978

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