While the need to address disparities in care is well known, few strategies for reducing disparities have been studied systematically.
Los Angeles—The number of Americans suffering from kidney stones between 2007 and 2010 nearly doubled since 1994, according to a study published by researchers at the University of California, Los Angeles (UCLA) and RAND.
“While we expected the prevalence of kidney stones to increase, the size of the increase was surprising,” says Charles D. Scales, Jr., MD, a Robert Wood Johnson Foundation/U.S. Department of Veterans Affairs Clinical Scholar in the departments of Urology and Medicine at UCLA. “Our findings also suggested that the increase is due, in large part, to the increase in obesity and diabetes among Americans.”
This is the first study to examine the new data from the National Health and Nutrition Examination Survey (NHANES) that was collected from 2007 to 2010. NHANES is a program of studies within the Centers for Disease Control and Prevention to assess the health and nutritional status of adults and children in the United States.
Scales and his colleagues reviewed responses from 12,110 people and found that between 2007 and 2010, 8.8 percent of the U.S. population had a kidney stone, or one out of every 11 people. In 1994 the rate was one in 20. No data about the national prevalence of kidney stones in the United States were collected between 1994 and 2007.
Because the survey also asks about other health conditions, and includes measurement of height and weight, the researchers were able to identify associations between kidney stones and other health conditions. The results suggest that obesity, diabetes, and gout all increase the risk of kidney stones.
The authors assert that these findings have important implications for the public as well as health care providers. “People should consider the increased risk of kidney stones as another reason to maintain a healthy lifestyle and body weight,” says Christopher S. Saigal, MD, MPH, senior author and principal investigator within RAND Health for the Urologic Diseases in America project. “But physicians need to rethink how to treat, and more importantly, prevent kidney stones.”
Currently, the primary approach to treating patients with kidney stones is to focus on the stones. Yet helping patients maintain a healthy diet and body weight can reduce the number of patients with kidney stones.
“Imagine that we only treated people with heart disease when they had chest pain or heart attacks, and did not help manage risk factors like smoking, high cholesterol, or high blood pressure,” says Scales. “This is how we currently treat people with kidney stones. We know the risk factors for kidney stones, but treatment is directed towards patients with stones that cause pain, infection, or blockage of a kidney rather than helping patients to prevent kidney stones in the first place.”
In an accompanying editorial, Brian Matlaga, MD, MPH, associate professor of urology at the Johns Hopkins University School of Medicine, writes that the cost of care for this disease is enormous, and there is no indication that the coming years will see any improvement in this trend. He also warns that, since approximately 10 percent of the population has the disease, a greater emphasis on prevention is imperative.
The study, “Prevalence of Kidney Stones in the United States,” is published in the July 2012 issue of European Urology.
For more than three decades, the Robert Wood Johnson Foundation Clinical Scholars program has fostered the development of physicians who are leading the transformation of health care in the United States through positions in academic medicine, public health, and other leadership roles. Through the program, future leaders learn to conduct innovative research and work with communities, organizations, practitioners, and policy-makers on issues important to the health and well-being of all Americans. This program is supported in part through collaboration with the U.S. Department of Veterans Affairs. For more information, visit http://rwjcsp.unc.edu.
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About the Robert Wood Johnson Foundation
The Robert Wood Johnson Foundation focuses on the pressing health and health care issues facing our country. As the nation’s largest philanthropy devoted exclusively to health and health care, the Foundation works with a diverse group of organizations and individuals to identify solutions and achieve comprehensive, measurable, and timely change. For 40 years the Foundation has brought experience, commitment, and a rigorous, balanced approach to the problems that affect the health and health care of those it serves. When it comes to helping Americans lead healthier lives and get the care they need, the Foundation expects to make a difference in your lifetime. Follow the Foundation on Twitter (www.rwjf.org/twitter) or Facebook (www.rwjf.org/facebook).
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