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Epidemiology of urinary stone disease

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Conclusion

A summary of the epidemiological risk factors for calcium stone formation is shown in Table. 4. At present, the data would seem to support the hypothesis that calcium stone disease is a multi-factorial disorder for which no single underlying metabolic or environmental factor is uniquely responsible. That is not to say that certain epidemiological factors are unimportant in the genesis of stones; rather they must be seen as aggravating factors that influence the probability of stone disease within the population by altering urinary composition in such a way as to increase the risk of abnormal crystalluria. It can be shown that increasing the mean value of one of the urinary risk factors in the population by only 10% may almost double the number of people in the upper tail of that distribution, in which the risk of stone formation is considerably greater. In addition, if a small percentage of the population is more metabolically sensitive to the stimulus responsible for the increase in the risk factor concerned, these individuals will show an exaggerated response to it, and this may more than double the number of people at high risk of developing stones. Examples of such aggravating factors include a high-animal protein and low-fibre diet, a high oxalate/calcium ratio in the diet, a hot climate, increased exposure to ultraviolet light, and certain metabolic disorders such as primary hyperparathyroidism, renal tubular acidosis and hereditary and enteric hyperoxaluria. This has been summarised by Robertson [22] in a general risk-factor model of calcium stone formation.

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  1. Department of Biological and Medical Research, King Faisal Specialist Hospital and Research Centre, Riyadh, Kingdom of Saudi Arabia

    W. G. Robertson

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Robertson, W.G. Epidemiology of urinary stone disease. Urol. Res. 18, S3–S8 (1990). https://doi.org/10.1007/BF00301521

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