Kidney stone risk, related ED visits rising in women

The risk of women developing kidney stones is rising, as is the number of cases being seen in U.S. emergency departments, while the rate of hospitalization for the disorder has remained stable, recent study findings indicate.

In the study, Henry Ford Hospital researchers examined trends in visits, hospitalization and charges during a recent 4-year period for patients who went to U.S. hospital emergency departments for treatment of kidney stones.

“While the number of patients visiting the emergency department had increased over that time period, it was women who had the greatest increase in visits,” said lead author Khurshid R. Ghani, MD, of Henry Ford’s Vattikuti Urology Institute, Detroit.

Citing recent population-based studies that have shown an increase in kidney stones among women, Dr. Ghani said his team’s findings provide further evidence that the risk of stones in women appears to be increasing.

“Women are becoming more and more obese. Obesity is a major risk factor for developing a kidney stone. And one fascinating thing about women versus men is obese women are more likely to develop a stone than an obese man,” said Dr. Ghani.

Drawing raw data from the Nationwide Emergency Department Sample, the authors, who published their findings online in the Journal of Urology (Aug. 7, 2013), looked for related emergency room visits from 2006–2009. They found a total of more than 3.6 million visits for upper urinary tract stones.

During the study period, the incidence of the disorder rose from 289 to 306 per 100,000 people. Among the study group, 12% were hospitalized as a result of their visits and rates remained stable during the study period. Women demonstrated a significant increase in visits (estimated annual percent change, +2.85%, p=.018).

 “Better diagnosis may be contributing to our findings that patients are not being admitted to the hospital as frequently as they had in the past,” Dr. Ghani said. “Also, medication can help with the spontaneous passage of these stones. As a result, some of these patients may be safely managed through the outpatient system with follow-up visits.”

For those who do get admitted to the hospital, the study showed that the highest likelihood was related to sepsis.

Most notably, in 2009, the charges for emergency department visits rose to $5 billion in 2009 from $3.8 billion in 2006.

“Fifteen years ago, around 5% to 10% of patients visiting the emergency department for a kidney stone would get a CT scan. Today, 70% of patients who visit the emergency department get a scan. While they’re wonderful tools of technology that allow an accurate diagnosis, they are expensive,” Dr. Ghani said.

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