The lifetime prevalence of nephrolithiasis in the US is estimated to be between 5% and 12%, with the probability of having a stone varying according to age, gender, race, and geographic location. Nephrolithiasis typically affects adult men more commonly than adult women, with a male to female ratio of 2 or 3:1. However, there is evidence that this difference in incidence between men and women is narrowing. In US men, the highest prevalence of nephrolithiasis is found in white men, followed by Hispanic men, Asian men, and black men. Among US women, the prevalence is highest among white women but lowest among Asian women. However, the rate of stone incidence is increasing at a faster rate for black people compared to white, and particularly for black women compared to men. Historically, stone occurrence was relatively uncommon before age 20 years but the incidence of stones in children and adolescents is rising. In adults, stone incidence peaks in the fourth to sixth decades of life. Nephrolithiasis has a higher prevalence in hot, arid, or dry climates, such as the mountains, desert, or tropical areas. Worldwide, regions of high stone prevalence include the US, British Isles, Scandinavian and Mediterranean countries, northern India and Pakistan, northern Australia, central Europe, portions of the Malay peninsula, and China. Heat exposure and dehydration are risk factors for nephrolithiasis. The prevalence and incident risk of nephrolithiasis are directly correlated with weight and BMI in both genders, although the magnitude of this association is greater in women than in men.
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