Kidney Stones (Nephrolithiasis)

A Frequent and Painful Consequence of Hyperoxaluria

The sharp onset of excruciating pain in the back, abdomen or side part of the body, accompanied by chills, nausea, vomiting and blood in the urine are the most common symptoms of a kidney stone, also known as nephrolithiasis. The kidney stone may take hours to days to pass or require surgical removal if it is too large to pass on its own. Obstruction caused by stones can lead to kidney failure and, in rare cases, surgical removal of the kidney (nephrectomy).

Kidney stones are composed of crystal deposits that form when there is an excess of certain substances in the urine, such as oxalate, cystine or calcium. About 70% to 80% of kidney stones are made of calcium oxalate1 and may be due to hyperoxaluria, a metabolic disorder caused by excess oxalate in the body.

Kidney stones are the most costly nonmalignant urological disease in the United States, accounting for over 3 million office visits and over 1 million emergency room visits annually. In 2006, the cost of managing kidney stones was estimated to be approximately $10 billion per year.2

Kidney stones are common, as ~10% of the population in the United States will experience a kidney stone at some point in their lives.3 Kidney stones can present at any age in both men and women regardless of race or ethnicity. According to the NIDDK-funded study Urological Diseases in America, kidney stone prevalence has increased by 50% in the past decade.4 Furthermore, an estimated 35% to 40% of patients have more than one kidney stone within 5 years of their initial diagnosis.5

The rising prevalence can also be attributed to changes in the underlying demographics of kidney stone formers. The greatest rates of increase were observed among adolescents, women and African-Americans. A study by Dr. Dwyer et al. found the incidence rate increased 4% per calendar year over a 25-year period, most significantly in adolescents.6

This increase in kidney stones may be related to the higher prevalence of obesity and diabetes, which have been associated with kidney stones. In addition to metabolic complications, emerging data indicates that kidney stones may also be associated with elevated risk of cardiovascular outcomes such as coronary heart disease, stroke and vascular calcification.7,8 

  

1. Coe FL, Evan A, Worcester E. Kidney stone disease. Journal of Clinical Investigation. 2005;115(10):2598-2608.
2. Urologic Diseases in America 2012. Table 14-47 Healthcare Cost and Utilization Project, National Ambulatory Medical Care Survey, National Hospital Ambulatory Medical Care Survey, i3 Claims Database; 2002- 2006.
3. Asplin JR, Favus MJ, Coe FL. Nephrolithiasis. In: Brenner BM, ed. Brenner and Rector's the kidney. 5th ed. Philadelphia: Saunders, 1996: 1893-935
4. Scales CD Jr., Smith AC, Hanley JM, Saigal CS; Urologic Diseases in America Project: Prevalence of kidney stones in the United States. Eur Urol 62: 160–165, 2012
5. Curhan GC. Diagnosis and acute management of suspected nephrolithiasis in adults. In: UpToDate, Forman JP (Ed), UpToDate, Waltham MA.
6. Dwyer ME. Temporal trends in incidence of kidney stones among children: a 25-year population based study. J Urol. 2012 Jul;188(1):247-52.

7. Liu, Yanqiong et al. Kidney Stones and Cardiovascular Risk: A Meta-analysis of Cohort Studies. American Journal of Kidney Diseases , Volume 64 , Issue 3 , 402 – 410.
8. Shavit L. Vascular Calcification and Bone Mineral Density in Recurrent Kidney Stone Formers  February 06, 2015 vol. 10 no. 2 278-285.