Kidney stone prevalence is increasing in women, study findings show

Data published in Canadian Urologic Association Journal show that the overall prevalence of kidney stones in US adults has remained relatively stable over the past decade but there has been a notable increase in prevalence among women.¹

This rise in prevalence was primarily driven by women under the age of 60.

The data were collected from the National Health and Nutrition Examination Survey (NHANES). In total, 38,329 patients aged 20 and older were captured in the analysis. The mean age of participants was 37.4 years (standard errors [SE], 0.2), and 51.1% (SE, 0.2%) of patients were female. Further, 62.6% (SE, 1.5%) of patients were White; 12.1% (SE, 0.8%) were Black; 10.3% (SE, 0.8%) were Mexican American; 8.4% (SE, 0.4%) were of another race or were multi-race; and 6.6% (SE, 0.5%) were of another Hispanic origin.

Data showed that among all patients, the weighted prevalence of kidney stones was 8.9% (SE, 0.6%) from 2007 to 2008, which remained relatively stable at 9.9% (SE, 0.6%) from 2017 to 2020 (P = .23). The rates were also relatively stable among male patients (11.5% vs 10.8%, P = 0.59) as well as across all racial/ethnic groups.

However, the rate increased significantly among female patients during the same period. 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).

The authors noted, “Historically, stone disease prevalence was higher in males than females, but this gap has narrowed in recent decades, especially among younger women.”

Specifically, the prevalence of kidney stones among women aged 20 to 39 increased from 4.7% (SE, 0.7%) between 2007 and 2008 to 6.4% (0.7%) between 2017 and 2020 (P = 0.12). An increase was also observed among women aged 40 to 64, rising from 10.7% (SE, 0.9%) between 2007 and 2008 to 11.7% (SE, 1.1%) from 2017 to 2020 (P = 0.48).

However, the prevalence of kidney stones showed a different trend among women aged 65 and older, increasing from 13.3% (SE, 1.1%) between 2007 and 2008 to 15.6% (SE, 1.1%) from 2015 to 2016. The rate decreased to 12.3% (SE, 0.9%) between 2017 and 2020 (P = 0.47).

According to the authors, the rise in kidney stone prevalence among women, particularly those younger than 60 years, could be due to a number of factors. For example, it could be due to an increase in the prevalence of severe obesity, which increased from 30.5% to 42.4% in US adults over the past 2 decades. The authors noted that obesity increases the risk of kidney stone formation, and this risk may be greater in obese women vs obese men.

They explained, “Obese women might also be at a higher risk of forming stones compared with obese men. A previous study determined that the relative risk of incident stones in obese men is 1.27 vs that in normal weight men, whereas in obese women the risk was up to 2.09 times higher than in normal weight women.”²

Other possible reasons for this rise, they suggest, could include metabolic syndrome, as well as shifting attitudes and cultural norms. On the latter, they speculate that more women in the workforce may lead to improved access to health insurance and, therefore, access to health care services, which may result in increased detection of asymptomatic stones.

However, they highlight several limitations of the current study, including its cross-sectional design and the potential for recall bias due to the reliance on self-report in the NHANES dataset. Additionally, they note, “Important factors, such as dietary habits, body composition, and environmental exposures, as well as stone-specific information like stone composition and 24-hour urinary metabolites, were not fully captured.”

REFERENCES

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

2. Taylor EN, Stampfer MJ, Curhan GC. Obesity, weight gain, and the risk of kidney stones. JAMA. 2005;293(4):455-62. doi:10.1001/jama.293.4.455