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In the Clinic |

Nephrolithiasis

David S. Goldfarb, MD
Ann Intern Med. 2009;151(3):ITC2-1. doi:10.7326/0003-4819-151-3-200908040-01002
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As many as 13% of men and 7% of women in the United States will have at least 1 kidney stone. Recent evidence suggests that the prevalence of kidney stones is increasing (1), perhaps because they are associated with hypertension, diabetes, obesity, chronic kidney disease, and the metabolic syndrome (2, 3). Between 1994 and 2000, outpatient visits for stone disease increased by 40%, and office visits increased by 43%. Stones recur frequently, with 50% of patients having a second stone within 5 years of the first one, and 80% having a second stone within 20 years. Kidney stones are expensive because urologic interventions are required for as many as 20% of episodes of renal colic. In addition, about 1% of the working population will be affected by stones in a given year, causing substantial indirect expense to employers through lost productivity (4). Stones can and should be prevented. Yet many urologists and nephrologists believe that most patients are not evaluated and not given appropriate advice or therapy, although data on this issue are lacking.

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