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National study of urolithiasis in the United states: an in-depth analysis based on the GBD study 2021

R. Ma¹, Y. Zhan¹, R. Shi¹, X. Ruan², C. Yao¹, S. Ali¹, T. Chun¹, A. Ng³, R. Na¹

¹The University of Hong Kong, Department of Surgery, Hong Kong, Hong Kong, China
²Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Department of Urology, Shanghai, China
³Queen Mary Hospital, Department of Surgery, Hong Kong, Hong Kong, China

Introduction:

Urolithiasis, characterized by the formation of urinary calculi, showed increasing prevalence in the United States over the past few decades. This study zooms in on urolithiasis within the United States by leveraging data from the Global Burden of Disease (GBD) study 2021 and other public datasets. The research focuses on disease burden and subsequently explores state-level disparities.

Material and methods:

In this project, we studied the incidence, mortality rates, and disability-adjusted life years (DALYs) associated with urolithiasis, quantified by number of patients, age-standardized rates, and percentage changes. We also elucidated the disparities observed in disease burden across various states and potential risk factor associations.

Results:

In 2021, the study identified 4.23 million incident cases of urolithiasis in the United States (95% UI 3.58–4.97). The age-standardized incidence rate (ASIR) decreased from 1990 to 2021 with a 46% reduction. The female-to-male incident cases ratio and ASIR ratio also decreased. In addition, the age-specific incidence rates peaked in the 65-69 age group for both sexes. Furthermore, urolithiasis accounted for 921 (95% UI 800–1,020) deaths in 2021, with an 178% increase from 1990. In 2021, urolithiasis contributed to 28,235 (95% UI 24,430-33,135) DALYs. The ASIR in 2021 was highest in West Virginia at 1,274 (95% UI 1,098–1,484) per 100,000, while the lowest was in the District of Columbia at 612 (95% UI 512–745). Notably, all states exhibited a decrease in ASIR of urolithiasis between 1990 and 2021. Potential risk factors associated with the disease burden difference include climate, diet, personal income levels, air and water conditions.