An analysis of the burden of urolithiasis: differences between the global, China, India and the United States, with projections through 2050.

Abstract

This report analyzes the patterns of urolithiasis in China, India, the United States, and globally from 1990 to 2021 using data from the Global Burden of Disease Study (GBD) 2021. Various techniques such as the Joinpoint model, age-period-cohort analysis, decomposition analysis, health inequities analysis, and the Bayesian age-period-cohort model were applied. According to the Joinpoint model, the average annual percent change (AAPC) for incidence, disability-adjusted life years, and mortality related to urolithiasis globally was negative. However, Indian women showed a positive AAPC of 0.20 in age-standardized incidence rate (ASIR). Both sexes in the United States showed positive AAPCs for age-standardized mortality rate (ASMR). The age-period-cohort analysis indicates that the peak ASIR occurs around ages 50-60. According to decomposition analysis, the main factors contributing to the rising burden of urolithiasis are population aging and growth, whereas changes in the disease's epidemiology slow its growth. Health inequities analysis shows increasing disparities between regions with high and low socio-demographic index (SDI). Forecasting models predict continued rise in prevalence without intervention. Overall, among the three countries, India faces the highest health burden, particularly among younger populations and women, whereas the United States experiences higher mortality rates among the elderly. Despite significant progress made by China in controlling urinary health burdens over the past three decades, the high incidence of urolithiasis and its subsequent impacts remain a concern, particularly in light of the country's demographic structure.