A Contemporary Analysis of the Prevalence and Incidence of Nephrolithiasis in the United States

Introduction: The prevalence of nephrolithiasis has been increasing in the United States. Our objective was to confirm the prevalence and incidence of nephrolithiasis in the United States between 2017 and 2020 and examine differences by demographic factors. Methods: Data from the National Health and Nutrition Examination Survey were analyzed to determine the prevalence and incidence of nephrolithiasis. Demographic factors were tested for associations with prevalence and incidence of nephrolithiasis. Chi-square tests and logistic regressions were performed. A P -value < .05 was statistically significant. Results: The overall nephrolithiasis prevalence was 9.8% (95% CI: 8.5%-11.2%), and the 12-month incidence was 1.8% (95% CI: 1.4%-2.3%). On multivariable analysis, age was associated with nephrolithiasis incidence; incidence was highest for the 30 to 39 year group (odds ratio (OR) 4.85, P ≤ .0001). No sex association was identified. Historically, the nephrolithiasis prevalence and incidence was greatest for White patients, but we identified that the other/multiracial group is now the highest at 13.9% and 4.3%, respectively; however, these results were not significantly different on multivariable analysis. Hypertension (OR 1.64, P = .03) was associated with nephrolithiasis prevalence and incidence, while obesity (OR 1.40, P = .002) was only associated with prevalence. Conclusions: The prevalence and incidence of nephrolithiasis in America was 9.8% and 1.8%, respectively, reproducing recent findings. White patients have historically had the highest prevalence/incidence of nephrolithiasis, but a nonsignificant increase for other/multiracial individuals was seen. Historically, men have had increased prevalence of stones, but no sex association was seen. Ongoing study is required to confirm these findings and identify factors driving these changes.