Recurrent Nephrolithiasis in Adults: Comparative Effectiveness of Preventive Medical Strategies Executive Summary

The lifetime incidence of kidney stones is approximately 13 percent for men and 7 percent for women.1,2 Reports conflict regarding whether incidence is rising overall but consistently report rising incidence in women and a falling male-to-female ratio.3-5 Although stones may be asymptomatic,6 potential consequences include abdominal and flank pain, nausea and vomiting, urinary tract obstruction, infection, and procedure-related morbidity. Following an initial stone event, the 5-year recurrence rate in the absence of specific treatment is 35 to 50 percent.7 Direct medical expenditures associated with kidney stones may exceed $4.5 billion annually in the United States.1,8