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. 1991 May;81(5):587–591. doi: 10.2105/ajph.81.5.587

Urolithiasis in Tennessee: an occupational window into a regional problem.

M J Thun 1, S Schober 1
PMCID: PMC1405067  PMID: 2014858

Abstract

BACKGROUND: Urinary tract stones (stones) are believed to be unusually common in the southeastern United States but neither the incidence of nor the risk factors for stones are known. METHODS: In three well-defined occupational populations in eastern Tennessee, we assessed the prevalence, incidence, and cumulative incidence of stones and measured biochemical risk factors for lithogenesis. RESULTS: The age-adjusted prevalence of stones was 18.5 percent in Tennessee compared to 7.7 percent among White males in US NHANES (prevalence ratio 2.4, 95% CI 1.7, 3.3). The cumulative incidence (risk) was 27.8 percent by age 65, higher than in any other reported population. Risk factors were age, a family history, and urinary saturation with calcium-oxalate (COAX). Persons with a positive family history and the highest measured CAOX index had a predicted lifetime risk of 88.8 percent. Biochemical factors affecting lithogenesis were hypercalciuria, hyperoxaluria, and low urine volume. CONCLUSION: Future research should characterize the geographic boundaries of a southeastern "stone-belt" and explore genetic and dietary hypotheses that might explain it.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. BOYCE W. H., GARVEY F. K., STRAWCUTTER H. E. Incidence of urinary calculi among patients in general hospitals, 1948 to 1952. J Am Med Assoc. 1956 Aug 11;161(15):1437–1442. doi: 10.1001/jama.1956.02970150005002. [DOI] [PubMed] [Google Scholar]
  2. Coe F. L., Kavalach A. G. Hypercalciuria and hyperuricosuria in patients with calcium nephrolithiasis. N Engl J Med. 1974 Dec 19;291(25):1344–1350. doi: 10.1056/NEJM197412192912510. [DOI] [PubMed] [Google Scholar]
  3. Hiatt R. A., Dales L. G., Friedman G. D., Hunkeler E. M. Frequency of urolithiasis in a prepaid medical care program. Am J Epidemiol. 1982 Feb;115(2):255–265. doi: 10.1093/oxfordjournals.aje.a113297. [DOI] [PubMed] [Google Scholar]
  4. Johnson C. M., Wilson D. M., O'Fallon W. M., Malek R. S., Kurland L. T. Renal stone epidemiology: a 25-year study in Rochester, Minnesota. Kidney Int. 1979 Nov;16(5):624–631. doi: 10.1038/ki.1979.173. [DOI] [PubMed] [Google Scholar]
  5. Ljunghall S., Lithell H., Skarfors E. Prevalence of renal stones in 60-year-old men. A 10-year follow-up study of a health survey. Br J Urol. 1987 Jul;60(1):10–13. doi: 10.1111/j.1464-410x.1987.tb09123.x. [DOI] [PubMed] [Google Scholar]
  6. Pak C. Y., Hill K., Cintron N. M., Huntoon C. Assessing applicants to the NASA flight program for their renal stone-forming potential. Aviat Space Environ Med. 1989 Feb;60(2):157–161. [PubMed] [Google Scholar]
  7. Pak C. Y., Skurla C., Harvey J. Graphic display of urinary risk factors for renal stone formation. J Urol. 1985 Nov;134(5):867–870. doi: 10.1016/s0022-5347(17)47496-9. [DOI] [PubMed] [Google Scholar]
  8. Parry E. S., Lister I. S. Sunlight and hypercalciuria. Lancet. 1975 May 10;1(7915):1063–1065. doi: 10.1016/s0140-6736(75)91830-9. [DOI] [PubMed] [Google Scholar]
  9. Sandler D. P., Smith J. C., Weinberg C. R., Buckalew V. M., Jr, Dennis V. W., Blythe W. B., Burgess W. P. Analgesic use and chronic renal disease. N Engl J Med. 1989 May 11;320(19):1238–1243. doi: 10.1056/NEJM198905113201903. [DOI] [PubMed] [Google Scholar]
  10. Schey H. M., Corbett W. T., Resnick M. I. Prevalence rate of renal stone disease in Forsyth County, North Carolina during 1977. J Urol. 1979 Sep;122(3):288–291. doi: 10.1016/s0022-5347(17)56370-3. [DOI] [PubMed] [Google Scholar]
  11. Shuster J., Finlayson B., Scheaffer R. L., Sierakowski R., Zoltek J., Dzegede S. Primary liquid intake and urinary stone disease. J Chronic Dis. 1985;38(11):907–914. doi: 10.1016/0021-9681(85)90126-2. [DOI] [PubMed] [Google Scholar]
  12. Shuster J., Finlayson B., Scheaffer R., Sierakowski R., Zoltek J., Dzegede S. Water hardness and urinary stone disease. J Urol. 1982 Aug;128(2):422–425. doi: 10.1016/s0022-5347(17)52951-1. [DOI] [PubMed] [Google Scholar]
  13. Sierakowski R., Finlayson B., Landes R. R., Finlayson C. D., Sierakowski N. The frequency of urolithiasis in hospital discharge diagnoses in the United States. Invest Urol. 1978 May;15(6):438–441. [PubMed] [Google Scholar]
  14. Williams H. E., Smith L. H., Jr Disorders of oxalate metabolism. Am J Med. 1968 Nov;45(5):715–735. doi: 10.1016/0002-9343(68)90207-6. [DOI] [PubMed] [Google Scholar]

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