Study on the Prevalence and Incidence of Urolithiasis in Germany Comparing the Years 1979 vs. 2000
Introduction
Epidemiological data on the occurrence of urolithiasis ranges between 2 and 20% [1], [2], [3]. Precise data on the epidemiology of a disease or disorder can only be determined if geographical position, race, age and sex, climate, nutrition and other environmental factors are also taken in consideration. The parameter “occurrence” is determined by two factors: (1) the incidence, i.e. the number of new disease cases per population measured over a given time interval and (2) the prevalence, i.e. the portion of people in a population who found to be with disease at a certain point in time. A representative survey of the incidence and prevalence of a disease is only possible using randomly selected samples of the general population questioned in face-to-face interviews or by telephone. Comparisons between different regions or countries are only permissible when the survey criteria are comparable. One explanation for the large fluctuations in the urolithiasis data gathered from different countries is that these were based only on selected groups, such as males over the age of 40, urban or rural populations.
Only few reports on the epidemiology of urolithiasis are available based on nation-wide surveys [4], [5], [6], [7]. The overall structure of the population has not always been taken into account in these studies [4], [8]. These studies produced prevalence data ranging from 4% [6] to 14.8% [7].
Chronological studies have shown that urolithiasis is on the increase. Within 10 years (1975–1985) the prevalence rose from 4 to 5.4% in Japan [5]. In 1979, we conducted a representative study for the Federal Republic of Germany, which showed the prevalence of urolithiasis to be 4.0% and the incidence 0.54% [6]. Using the same survey structure, this survey was repeated in 2001, so that reliable data on the development of urolithiasis would be obtained over the 22-year period.
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Materials and methods
In co-operation with INFAS (Institute for Applied Social Science) two representative, epidemiological surveys on urolithiasis were conducted (1979 and 2001).
In each case the questions relating to urolithiasis were posed within the framework of a multi-topic survey. In 1979, the survey was conducted face-to-face on a representative sample of 10,130 people. In 2001, 7500 people were included in the survey and were asked by telephone interviews. They were selected by following different criteria
Prevalence
The prevalence of urolithiasis has increased from 4.0 to 4.7% within 22 years (Table 1).
In the year 2001, 5.5% of males and 4.0% of females stated that they had already suffered from urinary stones once or more. The mean ratio between male and female was 1.4:1.
For patients over the age of 50 the prevalence was 9.7% for males and 5.9% for females (Fig. 1).
Analysis of the age when urolithiasis occurred for the first time amongst all stone patients interviewed in 2001 revealed a marked increase in
Discussion
In former times, most epidemiological studies of urolithiasis were based on hospital statistics, general practice surveys or selected group surveys [9], [10]. These produced many interesting details regarding this multifactorial disease, but, for a number of different epidemiological reasons, they are inadequate for determining the true prevalence and incidence in a population. Furthermore, a comparison between different countries, and a chronological assessment is not possible using data from
Acknowledgements
This study was supported by grants of the German Society of Shock Wave Lithotripsy, Dornier Medizintechnik (Wessling/Germany), Philips Medizin Systeme (Hamburg/Germany) and STORZ Medical (Kreuzlingen/Germany).
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