Part 2 book “Practical nephrology” has contents: Renal stone disease, kidney cancer, inherited renal tumour syndromes, polycystic kidney disease, other cystic kidney diseases, inherited metabolic disease, anaemia management in chronic kidney disease, setting up and running a haemodialysis service, peritoneal dialysis prescription, and other contents. | Renal Stone Disease 36 Shabbir H. Moochhala and Robert J. Unwin Changes in Epidemiology Associations with Other Disorders Urinary tract stone disease is common, important and increasing: the lifetime prevalence of stones is ~10 % in developed countries, and it disproportionately affects people of working age. After passage of a first stone, the risk of recurrence is 40 % at 5 years and 75 % at 20 years [1]. The incidence of stone disease has always been higher in certain areas such as the Arabian Gulf countries but is increasing internationally [2, 3]. Some of this is due to improvements in stone detection using CT scanning, but changes in dietary and fluid intake habits [4–7] and increased rates of obesity and metabolic syndrome [7, 8] are more important contributors. The incidence of stones in children has increased by 19 % in the last 10 years, the age at first presentation is reducing, and the traditional male to female ratio of 3:1 is changing to a greater proportion of women. Stone disease is a major contributor to the total number of urological procedures performed in the UK, with an increase of 63 % between 2000 and 2010 [3]. In 2009–2010 there were over 83,000 stone-related hospital attendances in England. This results in a major cost burden, with direct and indirect costs associated with kidney stones estimated at over $5 billion annually in the USA [9]. There is increasing evidence that calcium renal stone disease is a generalised metabolic disorder in its own right, rather than simply an associated feature or merely a cause of urinary tract obstruction. Stone formers of all types: 1. Are at increased risk of developing CKD compared to non-stone formers (over 8-year follow-up) [10] 2. Have lower bone mineral density when compared with the general population [11] 3. Are associated with a higher incidence of metabolic syndrome and increased cardiovascular risk [12], with a 30 % increased risk of myocardial infarction over a 9-year period .
