Study data point to increasing global incidence of urolithiasis

Data from a recent study show that the global incidence and deaths of urolithiasis have increased substantially over the past 3 decades, suggesting that the condition continues to pose a significant health care burden worldwide.¹

“[Urolithiasis] is recognized as the second most expensive urological disease, with projections indicating its economic burden will continue to escalate,” commented senior author Dr. Guohua He, in a news release on the findings.²

For the study, the investigators assessed data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 database, specifically looking at trends from 1990 to 2021. The GBD 2021 database includes insights across 204 countries and territories worldwide.

Overall, data showed that the total numbers of incidence, disability-adjusted life years (DALYs), and mortality of urolithiasis have increased globally over the 30-year time period assessed.

However, age-standardized rates (ASRs) have decreased. From 1990 to 2021, the estimated annual percentage change (EAPC) in age-standardized incidence was -0.87 (95% CI, −0.91 to −0.84), and the EAPC in age-standardized DALY rates was −1.15 (95% CI, −1.28 to −1.02). Age-standardized DALY rates (ASDRs) also showed an overall decline.

The data did, however, show disparities in urolithiasis burden based on age, sex, and socioeconomic status. Specifically, in 2021, the age-standardized incidence rate (ASIR) and age-standardized mortality rate (ASMR) were both significantly higher in males than in females. Notably, despite the overall declines in ASMR, data showed increasing trends in ASMR among females from 2009 to 2019 (APC, 1.57%).

The authors also noted, “The sex disparities in the age-standardized DALY rate (ASDR) and ASMR of urolithiasis were negatively correlated with the [sociodemographic index.]”

In furthering assessing these gender disparities, the investigators found a decrease in the global male-to-female ASIR ratio from 1990 to 2021 (AAPC = −0.35%, 95% CI = −0.37% to −0.33%). The male-to-female ASDR ratio increased from 1990 to 2005, followed by a decrease. Similarly, the male-to-female ASMR ratio remained stable from 1990 to 2007, followed by a decreasing trend from 2007 to 2018.

The investigators also observed regional variations in urolithiasis burden. While ASIR decreased worldwide, areas such Trinidad and Tobago, the United States Virgin Islands, and Grenada showed significant increases over the study period.

Of the 21 geographic regions assessed, East Europe had the highest ASIR, ASDR, and ASMR in 2021, with rates of 3557.08 (95% UI, 2986.04 to 4230.09), 22.82 (95% UI, 19.42 to 28.00), and 0.62 (95% UI, 0.56 to 0.72) per 100,000 population, respectively. Further, the greatest increasing trends in ASIR, ASDR, and ASMR from 1990 to 2021 were observed in Tropical Latin America, with EAPCs of 1.57 (95% UI, 1.12 to 2.02), 2.90 (95% UI, 2.65 to 3.16), and 3.70 (95% UI, 3.48 to 3.92), respectively. ASIR was found to be positively correlated with the SDI.

“Over the past 30 years, Tropical Latin America has experienced significant economic development, improving access to public medical assistance and increasing the use of medical imaging, which has heightened the diagnostic rate of asymptomatic urinary stones,” the authors explained.¹ “Therefore, countries and regions experiencing rapid economic development must be vigilant against the rapid rise in urolithiasis and implement preventive measures.”

Notably, data revealed that China has made considerable progress in reducing the burden of urolithiasis. In 2021, the ASIR of urolithiasis was markedly lower in China compared with the global average, with a rate of 964.70 per 100,000 population (95% UI, 801.26 to 1175.09 per 100,000 pop). The decline in ASIR from 1990 to 2021 was also more pronounced in China compared with the global average, as were the ASRs of DALY, years lived with disability, and years of life lost in 2021.

“This progress may be attributed to improvements in dietary habits, active health education, significant advancements in healthcare infrastructure and technology, and optimized public health strategies,” explained Professor Tianxin Lin, in the news release.² Preventionand treatment strategies such as the ones introduced in China should be promoted worldwide, according to the authors.

Overall, based on these findings, the authors concluded, “Urolithiasis exhibits a significant sex disparity worldwide, particularly in low-SDI countries and territories. Therefore, special attention must be directed toward addressing the inequity in the burden of urolithiasis, emphasizing low-SDI countries and territories and the female population.”

REFERENCES

1. Zheng J, Zhang W, Zhang J, et al. Trends and sex disparities in the burden of urolithiasis in 204 countries and territories, 1990–2021. Chin Med J (Engl). 2025. doi:10.1097/CM9.0000000000003622

2. Chinese Medical Journal study reports on the sex disparity and global temporal trends in the disease burden of urolithiasis. News release. Chinese Medical Journals Publishing House Co., Ltd. August 18, 2025. Accessed August 19, 2025. https://www.eurekalert.org/news-releases/1095002