Age-gender characteristics of urolithiasis: analysis of 5-year prevalence rates among men and women

Introduction. Urolithiasis ranks among the most common and socially significant urological conditions. Male sex and advancing age are well‑recognized risk factors for stone disease. In the general population, the likelihood of urolithiasis rises with age. At the same time, men and women differ not only in the prevalence of urolithiasis but also in the pattern of sex‑specific risk factors.

Objective. To assess the age-gender characteristics of the urolithiasis.

Materials & methods. The present study included 23464 patients hospitalized in the Urology division of Savelieva Moscow City Clinical Hospital No. 31 from 2019 to 2024. The study group of patients consisted of patients with an established diagnosis of urolithiasis, while all other patients without urolithiasis formed the control group.

Results. Urolithiasis was identified in 38.2% of respondents (8,972 patients). Among patients with urolithiasis, 55.9% were men (mean age 50.1 years) and 44.1% were women (mean age 54.5 years). The prevalence of urolithiasis in men increases steadily with age and reaches a plateau between 30–34 and 45–49 years. The highest odds of urolithiasis are observed in the 35–39-year age group: in these patients, the odds are 4.3-fold higher than in men aged 18–24 years (OR 4.326; 95% CI 3.433–5.449; p < 0.001), corresponding to a 68.8% probability of urolithiasis. Thereafter, the odds of urolithiasis gradually decrease. In women, the prevalence of urolithiasis also increases with age, peaking at 60–64 years. Thus, in women aged 60–64 years, the odds of urolithiasis are 3.4-fold higher than in those aged 18–24 years (OR 1.553; 95% CI 1.242–1.943; p < 0.001), corresponding to a 53.7% probability of urolithiasis. In patients aged 65 years and older, the odds of urolithiasis remain consistently high.

Conclusion. Advancing age in men is associated with a lower probability of urolithiasis, whereas advancing age in women is associated with a higher probability of urolithiasis. These patterns may reflect age‑related changes in sex hormone levels, with androgens regarded as promoters of stone formation and estrogens as inhibitors of stone formation.

1. Lang J, Narendrula A, El-Zawahry A, Sindhwani P, Ekwenna O. Global Trends in Incidence and Burden of Urolithiasis from 1990 to 2019: An Analysis of Global Burden of Disease Study Data. Eur Urol Open Sci. 2022;35:37-46. DOI: 10.1016/j.euros.2021.10.008

2. Zi H, Liu MY, Luo LS, Huang Q, Luo PC, Luan HH, Huang J, Wang DQ, Wang YB, Zhang YY, Yu RP, Li YT, Zheng H, Liu TZ, Fan Y, Zeng XT. Global burden of benign prostatic hyperplasia, urinary tract infections, urolithiasis, bladder cancer, kidney cancer, and prostate cancer from 1990 to 2021. Mil Med Res. 2024;11(1):64. DOI: 10.1186/s40779-024-00569-w

3. GBD 2021 Urolithiasis Collaborators. The global, regional, and national burden of urolithiasis in 204 countries and territories, 2000-2021: a systematic analysis for the Global Burden of Disease Study 2021. EClinicalMedicine. 2024;78:102924. DOI: 10.1016/j.eclinm.2024.102924

4. Kaprin A.D., Apolikhin O.I., Sivkov A.V., Anokhin N.V., Gadzhiev N.K., Malkhasyan V.A., Akopyan G.N., Prosyannikov M.Yu. The incidence of urolithiasis in the Russian Federation from 2005 to 2020. Experimental and Clinical Urology. 2022;15(2)10-17. (In Russian). DOI: 10.29188/2222-8543-2022-15-2-10-17

5. Gadzhiev N, Prosyannikov M, Malkhasyan V, Akopyan G, Somani B, Sivkov A, Apolikhin O, Kaprin A. Urolithiasis prevalence in the Russian Federation: analysis of trends over a 15-year period. World J Urol. 2021;39(10):3939-3944. DOI: 10.1007/s00345-021-03729-y

6. Ma Y, Cheng C, Jian Z, Wen J, Xiang L, Li H, Wang K, Jin X. Risk factors for nephrolithiasis formation: an umbrella review. Int J Surg. 2024;110(9):5733-5744. DOI: 10.1097/JS9.0000000000001719

7. Basiri A, Kashi AH, Zahir M, Omran HS, Borumandnia N, Taheri M, Golshan S, Naroie B, Hajebrahimi S. Exploring the Impact of Family History, Demographics and Ecological Factors on Urolithiasis Prevalence: Insights from a Nationwide Study. Urol Res Pract. 2024;50(2):115-120. DOI: 10.5152/tud.2024.23221

8. Huang A, Huang W, Ye Y, Liu L, Wang H, Bian X, Qin Y, Guo Z, Chen W. High composite dietary antioxidant index is associated with reduced risk of kidney stones: a cross-sectional analysis of NHANES 2007-2020. Nutr Res. 2024;128:60-69. DOI: 10.1016/j.nutres.2024.06.006

9. Sánchez C, Larenas F, Arroyave JS, Connors C, Giménez B, Palese MA, Fulla J. Artificial Intelligence in Urology: Application of a Machine Learning Model to Predict the Risk of Urolithiasis in a General Population. J Endourol. 2024;38(8):712-718. DOI: 10.1089/end.2023.0702

10. Xu JZ, Li C, Xia QD, Lu JL, Wan ZC, Hu L, Lv YM, Lei XM, Guan W, Xun Y, Wang SG. Sex disparities and the risk of urolithiasis: a large crosssectional study. Ann Med. 2022;54(1):1627-1635. DOI: 10.1080/07853890.2022.2085882

11. Zhang L, Zhang X, Pu Y, Zhang Y, Fan J. Global, Regional, and National Burden of Urolithiasis from 1990 to 2019: A Systematic Analysis for the Global Burden of Disease Study 2019. Clin Epidemiol. 2022;14:971-983. DOI: 10.2147/CLEP.S370591

12. Qiao Y, Xiao H, Ye Z, Yu Y, Fan X, Wang O, Li R, Luo H, Liu H, Hu S, Ji Z. Prevalence of Urolithiasis in a China Hospital: A Cross-Sectional Study. Arch Esp Urol. 2023;76(1):90-97. DOI: 10.56434/j.arch.esp.urol.20237601.9

13. Alathel A, Alfraidi O, Alsayyari ASA, Aljaafri B, Alsalamah F, Almeneif H, Alsaif A. Exploring the incidence and characteristics of urolithiasis in the central region of Saudi Arabia: Insights from a prominent medical center. Urol Ann. 2024;16(3):233-240. DOI: 10.4103/ua.ua_1_24

14. Huang H, Li M, Fan H, Bai R. Temporal Trend of Urolithiasis Incidence in China: An Age-Period-Cohort Analysis. Int J Gen Med. 2021;14:2533-2539. DOI: 10.2147/IJGM.S313395

15. Nguyen LD, Nguyen TT, Mai LV, Bui PV, Nguyen VT, Truong GT, Luu MT, Duong HT, Vu LD, Hoang TT. The first epidemiology of urolithiasis in Northern Vietnam: Urinary stone composition, age, gender, season, and clinical features study. Urologia. 2024;91(1):42-48. DOI: 10.1177/03915603231208090

16. Li Y, Duan X, Wan S, Wang X, Hao Y. Association analysis of dry heat or wet cold weather and the risk of urolithiasis hospitalization in a southern Chinese city. Sci Rep. 2025;15(1):1651. DOI: 10.1038/s41598-025-86262-x

17. Yoshioka I, Tsujihata M, Okuyama A. Effect of sex hormones on crystal formation in a stone-forming rat model. Arch Ital Urol Androl. 2011;83(1):26-30. PMID: 21585166

18. Naghii MR, Jafari M, Mofid M, Eskandari E, Hedayati M, Khalagie K. The efficacy of antioxidant therapy against oxidative stress and androgen rise in ethylene glycol induced nephrolithiasis in Wistar rats. Hum Exp Toxicol. 2015;34(7):744-754. DOI: 10.1177/0960327114558889

19. Liang L, Li L, Tian J, Lee SO, Dang Q, Huang CK, Yeh S, Erturk E, Bushinsky D, Chang LS, He D, Chang C. Androgen receptor enhances kidney stone-CaOx crystal formation via modulation of oxalate biosynthesis & oxidative stress. Mol Endocrinol. 2014;28(8):1291-1303. DOI: 10.1210/me.2014-1047

20. Elshal AM, Shamshoun H, Awadalla A, Elbaz R, Ahmed AE, El-Khawaga OY, Shokeir AA. Hormonal and molecular characterization of calcium oxalate stone formers predicting occurrence and recurrence. Urolithiasis. 2023;51(1):76. DOI: 10.1007/s00240-023-01440-8

21. Fang H, Deng J, Chen Q, Chen D, Diao P, Peng L, Lai B, Zeng Y, Han Y. Univariable and multivariable mendelian randomization study revealed the modifiable risk factors of urolithiasis. PLoS One. 2023;18(8):e0290389. DOI: 10.1371/journal.pone.0290389

22. Prochaska M, Taylor EN, Curhan G. Menopause and Risk of Kidney Stones. J Urol. 2018;200(4):823-828. DOI: 10.1016/j.juro.2018.04.080

23. Shakhssalim N, Gilani KR, Parvin M, Torbati PM, Kashi AH, Azadvari M, Golestan B, Basiri A. An assessment of parathyroid hormone, calcitonin, 1,25 (OH)2 vitamin D3, estradiol and testosterone in men with active calcium stone disease and evaluation of its biochemical risk factors. Urol Res. 2011;39(1):1-7. DOI: 10.1007/s00240-010-0276-3

24. Zhu W, Zhao Z, Chou FJ, Zuo L, Liu T, Bushinsky D, Chang C, Zeng G, Yeh S. The Protective Roles of Estrogen Receptor β in Renal Calcium Oxalate Crystal Formation via Reducing the Liver Oxalate Biosynthesis and Renal Oxidative Stress-Mediated Cell Injury. Oxid Med Cell Longev. 2019;2019:5305014. DOI: 10.1155/2019/5305014

25. Soraci L, Ärnlöv J, Carlsson AC, Feldreich TR, Larsson A, Roller-Wirnsberger R, Wirnsberger G, Mattace-Raso F, Tap L, Formiga F, Moreno- González R, Soltysik B, Kostka J, Artzi-Medvedik R, Melzer I, Weingart C, Sieber C, Marcozzi S, Muglia L, Lattanzio F; Screening for CKD among Older People across Europe (SCOPE) study investigators. Associations between plasma osteopontin, sex, and 2-year global and cardiorenal outcomes in older outpatients screened for CKD: a secondary analysis of the SCOPE study. Clin Kidney J. 2024;17(12):sfae336. DOI: 10.1093/ckj/sfae336

26. Iguchi M, Takamura C, Umekawa T, Kurita T, Kohri K. Inhibitory effects of female sex hormones on urinary stone formation in rats. Kidney Int. 1999;56(2):479-485. DOI: 10.1046/j.1523-1755.1999.00586.x

27. Yagisawa T, Ito F, Osaka Y, Amano H, Kobayashi C, Toma H. The influence of sex hormones on renal osteopontin expression and urinary constituents in experimental urolithiasis. J Urol. 2001;166(3):1078-1082. PMID: 11490302.

28. Sueksakit K, Thongboonkerd V. Protective effects of finasteride against testosterone-induced calcium oxalate crystallization and crystal-cell adhesion. J Biol Inorg Chem. 2019;24(7):973-983. DOI: 10.1007/s00775-019-01692-z

29. Peerapen P, Thongboonkerd V. Protective Cellular Mechanism of Estrogen Against Kidney Stone Formation: A Proteomics Approach and Functional Validation. Proteomics. 2019;19(19):e1900095. DOI: 10.1002/pmic.201900095