Editorial Comment: Association of Prevalent Kidney Stone Disease With All-Cause Mortality Among U.S. Adults: The National Health and Nutrition Examination Survey 2007 to 2018

It is well documented that chronic medical conditions such as obesity, diabetes, hypertension, metabolic syndrome, and cardiovascular disease affect overall survival. All are associated with kidney stone formation.1-3 The concept of increased mortality in patients with kidney stones due to the association with these conditions is sobering for both the patient and the treating physician. But how much does stone disease play in overall survival? This updated look at the effect of kidney stones on mortality dispels some of that concern.4 The National Health and Nutrition Examination Survey (NHANES) cohorts have long been used in epidemiologic kidney stone research as they are large, provide a huge amount of data, have good long-term follow-up, and provide useful information about overall effects of disease processes on long-term outcomes and mortality.5 Like the earlier analysis with the NHANES III cohort, after adjusting for confounding factors, this updated cohort, NHANES 2007 to 2018, similarly failed to show any negative effect of kidney stone disease on survival. In comparing the 2 cohorts together, they notice a trend toward improving survival in recurrent stone formers, which suggests that perhaps we are doing a better job managing these patients. Although none of this is groundbreaking, it is nice to know that this is still a negative study. As we continue to improve the treatment of stone disease, it is probably more important to focus on the underlying associated chronic conditions that have a greater impact on overall mortality.