Ian Metzler, MD, on the increasing prevalence of kidney stones in women

The prevalence of kidney stones has been increasing among women over the past decade, slowly narrowing the gap between men and women in the burden of stone disease. A recent study published in Canadian Urologic Association Journal showed that between 2007 and 2008, the prevalence of kidney stones among women was 6.5% (SE, 0.5%), which rose to 9.1% (SE, 0.9%) from 2017 to 2020 (P = .01).¹

In a recent interview with Urology Times®, Ian Metzler, MD, MTM, discusses this trend and considers possible contributing factors.

“We were always taught that the breakdown is usually more towards men in terms of incidence and prevalence, but that's changing,” he said. “It's not the kind of equality that we like to see, but women are quickly catching up with men in terms of their incidence and frequency of kidney stones.”

Metzler is an assistant professor of urology at Oregon Health & Science University School of Medicine in Portland, Oregon.

There are several possible contributing factors to the rising incidence in women, Metzler explains. The first: dietary patterns.

“I think it's primarily due to dietary changes that are more and more prevalent regardless of sex,” he explained. “The things that we worry about most are the increase in ultra processed foods, sodium-containing foods, fast foods, sugar-containing beverages—particularly sodas—and then, of course, the resulting epidemics of diabetes and obesity that increase your risk for kidney stones, all of which are affecting women in greater quantities.”

He also noted several other explanations, such as a lack of water consumption for those working in jobs with manual labor or very busy shift work, which women are increasingly becoming involved in. He also says that he is seeing more infection-related stones in his practice. The rising prevalence in stones among women, then, could be explained by their greater risk for urinary tract infection.

REFERENCE

1. Chen KW, Meskawi M, Miller LE, et al. Trends in kidney stone prevalence among U.S. adults: a concerning contemporary gender analysis from the NHANES database. Can Urol Assoc J. 2025;19(2):58-60. doi:10.5489/cuaj.8935