Nephrolithiasis in the elderly

A. Carella 1, S. Leo 1, B. Infante 1, A. Hoznek 2, G. Grandaliano 1, G. Stallone 1

1 Nephrology Dialysis and Transplantation Unit, Department of Medical and Surgical Sciences, University of Foggia, Italy; 2 Department of Urology, Henri Mondor Hospital, Créteil, France

Nephrolithiasis is a disease characterized by the presence of crystal concretions in the urinary tract. It is widely spread worldwide, both in the Western and non-Western countries. Several studies have pointed out a rising prevalence and incidence of kidney stone disease in the elderly population in the last several decades. 

Data from large cohort studies suggest an association between the increased risk of stones formation and dietary factors such as low fluid intake, low calcium intake, high sodium intake, high animal protein intake, and high fructose intake. The kidney stones risk may also be increased by medical conditions such as obesity, diabetes, primary hyperparathyroidism, and gout. Stones may be asymptomatic or may show symptoms such as abdominal and flank pain, nausea and vomiting, urinary tract obstruction, and infections. 

This review aims to outline specific features of nephrolithiasis in the elderly population, including lifestyle, eating habits, hormonal modifications and comorbidities that may affect stone formation. We also assessed the impact of age on diagnostic and therapeutic pathways. Evidence suggest that age per se should not preclude standard treatment but should be taken in due account during the decision-making process.

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