Changing gender prevalence of stone disease.
OBJECTIVE
Recent studies suggest that the incidence of renal stone formation has been increasing and the male predominance of nephrolithiasis is decreasing, which may be due to changes in diet and lifestyle. We examined changes in the prevalence by gender of inpatient hospital discharges for urinary stone disease.


METHODS
The Nationwide Inpatient Sample was used for analysis. Discharges with an International Classification of Diseases, 9th revision, Clinical Modification principal diagnosis of 592.0 (calculus of kidney) or 592.1 (calculus of ureter) from 1997 to 2002 were included in the investigation.


RESULTS
An estimated mean+/-SE 1,013,621+/-19,310 discharges for stone disease occurred from 1997 to 2002. Discharges for renal calculus increased by 18.9% during the study period (p<0.001), while discharges for ureteral calculus remained relatively constant. After adjusting for population changes discharges for renal calculi increased by 14.2% (p=0.002). In females discharges for renal calculi increased by 21.0% and discharges for ureteral calculi increased by 19.2% (each p<0.001). After adjusting for population changes renal calculus and ureteral calculus discharges in females increased by 22.0% (p=0.001) and 14.5% (p=0.005), respectively.


CONCLUSIONS
In this nationally representative sample the population adjusted rate of discharges for stone disease in females dramatically increased from 1997 to 2002. This alteration represents a change in the prevalence by gender of treated stone disease from a 1.7:1 to 1.3:1 male-to-female ratio. It may reflect variations in the underlying prevalence by gender of stone disease. We speculate that the increasing incidence of nephrolithiasis might be due to lifestyle associated risk factors, such as obesity.
Scales
Charles D
CD
Comprehensive Kidney Stone Center, Division of Urology, Department of Surgery, Duke University Medical Center, Durham, North Carolina 27710, USA.
Curtis
Lesley H
LH
Norris
Regina D
RD
Springhart
W Patrick
WP
Sur
Roger L
RL
Schulman
Kevin A
KA
Preminger
Glenn M
GM
D016208:Databases, Factual; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007669:Kidney Calculi / Q000453:epidemiology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D017678:Sex Distribution; D014481:United States / Q000453:epidemiology; D014514:Ureteral Calculi / Q000453:epidemiology* / Q000628:therapy