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Risk factors for calcium stones in adults

Gary C Curhan, MD, ScD
Section Editor
Stanley Goldfarb, MD
Deputy Editor
Albert Q Lam, MD


Renal stone disease (nephrolithiasis) is a relatively common problem [1,2]. A study based upon the National Health and Nutrition Examination Survey (NHANES) estimated that 19 percent of men and 9 percent of women will be diagnosed with a kidney stone by the age of 70 years [1].

In a report from the third NHANES, the population prevalence increased from 3.8 percent in the period from 1976 to 1980 to 5.2 percent in the period from 1988 to 1994 [2]. The prevalence increased in men and women, and in whites and blacks. Although one study suggested that the incidence rates since then may have leveled off [3], the 2007 to 2010 NHANES data found a continued increase in prevalence to 8.8 percent in the United States population [1].

Approximately 75 percent of patients with nephrolithiasis form calcium stones, most of which are composed primarily of calcium oxalate or, less often, calcium phosphate [1,4]. Pure uric acid stones make up less than 10 percent of all stones.

This topic provides an overview of the pathogenesis and risk factors for calcium nephrolithiasis. The evaluation and management of the patient with kidney stones, prevention of recurrent calcium stones, and related topics are discussed separately. (See "Diagnosis and acute management of suspected nephrolithiasis in adults" and "Evaluation of the adult patient with established nephrolithiasis and treatment if stone composition is unknown" and "Prevention of recurrent calcium stones in adults".)


Stones are more likely to occur when one or more factors are present that lead sequentially to supersaturation of the urine, the formation of crystals, and their subsequent aggregation into a clinically detectable stone. Even individuals without nephrolithiasis can excrete crystals; however, calcium oxalate stone formers are more likely to have crystalluria than controls, and the presence of crystalluria substantially increases the likelihood of stone formation (picture 1A-B) [5].

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Literature review current through: Nov 2017. | This topic last updated: Nov 10, 2016.
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