The prevalence of urolithiasis in the United States and the cost of its care will increase dramatically in the future if the epidemics of obesity and diabetes mellitus continue unchecked, according to analyses conducted by researchers at the University of Texas Southwestern Medical Center, Dallas.
San Diego-The prevalence of urolithiasis in the United States and the cost of its care will increase dramatically in the future if the epidemics of obesity and diabetes mellitus continue unchecked, according to analyses conducted by researchers at the University of Texas Southwestern Medical Center, Dallas.
Using cost data from the Urologic Diseases in America (UDA) project and urolithiasis prevalence data from National Health and Nutrition Examination Survey (NHANES) datasets, the authors determined that in 2007, the total lifetime prevalence of stone disease was 8.83% and the annual stone-related health care cost was $3.55 billion (in 2012 dollars). Applying estimates on the prevalence of obesity and diabetes from NHANES, the Centers for Disease Control and Prevention, and other national datasets, they calculated that increases in the prevalence of obesity and diabetes between 2007 and 2010 increased the stone prevalence rate during that period by 0.07% and 0.17%, respectively, leading to increases of $30 million and $69 million, respectively, in stone-related health care costs.
Factoring in the effect of future population growth and based on projections about future increases in rates of obesity and diabetes, it was determined that by 2030, stone-related health care costs could increase by an additional $200 million annually.
‘Staggering’ increase in costs predicted
“It is well known from epidemiologic and basic science studies that obesity and diabetes mellitus are associated with urolithiasis. If the projections on increases in the prevalence of these conditions are correct, there will be a staggering increase in health care expenditures for urolithiaisis,” said first author Jodi A. Antonelli, MD, an endourology fellow at UT Southwestern who presented the findings at the AUA annual meeting in San Diego.
“We hope these data will bring more attention and support to strategies for addressing the comorbidities that are associated with stone disease and for preventing stone disease in the future,” added Dr. Antonelli, who worked on the study with Margaret S. Pearle, MD, PhD, Yair Lotan, MD, and Naim Maalouf, MD.
As the most recent UDA data on health care costs for urolithiasis were available for the year 2000, the investigators first estimated stone prevalence for that year using information from available NHANES datasets. The cost per percent prevalence was then estimated from UDA data and converted to 2012 dollars using an inflation calculation. Calculations on prevalence of stones based on obesity and diabetes diagnosis were done using previously reported odds ratios on urolithiasis risk by body mass index category and diabetes (Eur Urol 2012; 62:160-5).UT