Optimizing kidney stone care with multidisciplinary collaboration and improved guideline adherence

r. Chen and colleagues have assessed trends in kidney stone disease (KSD) prevalence in the adult American population in their analysis of data from NHANES database information. 1Prior to reading the article, I expected that KSD incidence would have risen across the American population over the study time period.That, however, was not the case, as there was no statistically significant difference in KSD prevalence as captured by the NHANES data between 2007 and 2017-2020 (8.9% vs. 9.9%, p=0.23), despite increases occurring in prior decades.The authors did identify that KSD prevalence increased significantly in females (6.5% vs. 9.1%, p=0.01) compared to males (11.5% vs. 10.8%,p=0.59) over the study timeframe.As noted in the study, KSD is a significant driver of economic burden, including healthcare utilization and lost economic productivity.At an estimated cost of $2 billion USD per year in 2000, 2 the cost of managing KSD is not insubstantial.Stones are not cancer, but the negative effects KSD has on the healthcare system and our society as a whole, including reductions in health-reported quality of life (HRQoL) metrics, 3 should not be discounted.The study authors outline some possible reasons for the increase in KSD prevalence in female patients, including metabolic issues that have been rising within the female population in recent decades.Specifically, they highlight the risks of obesity, diabetes, metabolic syndrome, and resultant inflammation that may be driving increases in KSD in the female population, as seen in this study.Other potential explanations, including societal changes that might create changes in kidney stone diagnosis, such as higher participation in the work force and potential of higher health insurance coverage for this patient population (a unique consideration for American populations than those in Canada), are discussed in the study.These are all interesting points beyond the scope of the study, but