II. Risk Factors: General
- Increases with advancing age up to 65 years
- Male gender (men account for 66% of cases)
- Geographic location (hot, arid climates)
- Southeastern United States ("stone belt")
- Mediterranean countries
- Middle Eastern countries
- Northern Australia
III. Risk Factors: Anatomic Abnormalities
IV. Risk Factors: Inherited Conditions
- Polycystic Kidney Disease
- Renal Tubular Acidosis Type I
- Cystinuria
- Hypocitraturia
- Hypercalciuria
- Prmary hyperoxaluria
- Lesch-Nyhan Syndrome
- 2,8-dihydroxyadenine
- Cystic Fibrosis
- Xanthinuria
V. Risk Factors: Gastrointestinal Disorders
-
Inflammatory Bowel Disease (Crohns Disease, Ulcerative Colitis)
- Higher risk of Calcium Oxalate Stones
- Urinary diversion (enteric hyperoxaluria)
- Intestinal resection
- Jejunoileal bypass (Bariatric Surgery)
- Intestinal malabsorption
VI. Risk Factors: Miscellaneous
- Hypertension
- Non-Alcoholic Fatty Liver Disease
- Gouty Arthritis
- Nephrocalcinosis
-
Hyperparathyroidism
- Higher risk of Calcium Oxalate Stones
- Sarcoidosis
VII. Risk Factors: Medications
VIII. Risk Factors: Dietary and Hydration Factors
- Low Urine Volume
- Inadequate access to hydration or restrooms
- Athlete
- Heat exposure
- Bowel Disease
- Bowel Surgery (e.g. Ileostomy)
- Infammatory bowel disease (e.g. Crohn's Disease)
- Chronic Diarrhea
- Peptic Ulcer Disease
- Other dietary factors
- Animal protein intake (see aciduria below)
- Purine Containing Foods and other protein intake
- High Oxalate Containing Foods (hyperoxaluria)
- Excessive Sodium intake (Hypercalciuria risk)
- Excessive carbohydrate intake
- Animal protein intake (see aciduria below)
-
Hypercalciuria (70% of stone formers)
- Type 1: Increased PTH (resorptive Hypercalciuria)
- Type 2: Increased Calcium absorption from gut
- Type 3: Increased Urinary Phosphorus loss
- Type 4: Increased Urinary Calcium loss
- Hyperoxaluria
- Citrate deficiency (not oxalate metabolism problem)
- Hypocitraturia (Distal Renal Tubular Acidosis)
- Hyperuricosuria
- Acidosis and aciduria (results in loss of citrate)
- Acetazolamide (Diamox)
- Renal Tubular Acidosis
- Protein loading (especially with animal protein)
- Bowel disease (see above)
IX. Risk Factor: Other risks for recurrent stone
- Early onset Urolithiasis (child or teen onset)
- Family History of stone formation
- Calcium Phosphate Stones
- Infection associated stones (Struvite Stones, carbonate apatite stones)
- Uric Acid stones
X. References
- Mobley (Feb 1999) Hospital Medicine, p. 21-38
- Fontenelle (2019) Am Fam Physician 99(8): 490-6 [PubMed]
- Frassetto (2011) Am Fam Physician 84(11): 1234-42 [PubMed]
- Goldfarb (1999) Am Fam Physician 60(8): 2269-76 [PubMed]
- Houshiar (1996) Postgrad Med 100(4): 131-8 [PubMed]
- Pietrow (2006) Am fam Physician 74(1): 86-94 [PubMed]
- Preminger (2007) J Urol 178(6): 2418-34 [PubMed]
- Skolarikos (2015) Eur Urol 67(4): 750-63 [PubMed]
- Trivedi (1996) Postgrad Med, 100(6): 63-78 [PubMed]
