Global, Regional, and National Burden of Urolithiasis from 1990 to 2019: A Systematic Analysis for the Global Burden of Disease Study 2019.

Introduction: To get insight into the temporal trends of urolithiasis, and thus decrease the health burden of urolithiasis, we comprehensively investigated the specific epidemiological indicators that varied among different countries and regions according to the diversity of geographic locations, gender, age, year, and socioeconomic status. Methods: In this study, we investigated the incidence, death, disability-adjusted life years (DALYs) of urolithiasis quantified by the number of patients, age-standardized rates, and estimated annual percentage changes based on geographic locations, gender, age, and year to decode the epidemiological characteristics using the data from 1990 to 2019 in the Global Burden of Disease database. Results: In 2019, more than 115 million (95% uncertainty interval [95% UI] 93-140) incident cases of urolithiasis occurred worldwide, and the age-standardized incidence rate (ASIR) (per 100,000 population) decreased from 1696.2 (1358.1-2078.1) in 1990 to 1394 (1126.4-1688.2) in 2019. Nearly 13,279 (95% UI: 10616-16267) died of urolithiasis, contributing to 0.6 million (0.5-0.7) DALYs in 2019. The highest age-standardized DALY rates (33.33 per 100 000 population) in 2019 were observed in Armenia, whereas the largest negative estimated annual percentage changes of DALYs were seen in Poland. The ASIR of males was higher than females. However, the ASIR EAPC of males was lower than females from 1990 to 2019. Males aged 50-54 years old were more likely to suffer from urolithiasis. Joinpoint regression model analyses suggested that the global age-standardized incidence and DALY rates of urolithiasis encountered a trend to decline over the past 30 years. Over the years, the attenuation of this disease was pinpointed to be weakly related to the Socio-demographic index. Conclusion: At the global level, both the incident and DALY cases experienced substantial growth compared to the absolute cases in 1990. However, global age-standardized incidence and DALY rate of urolithiasis were observed to decline from 1990 to 2019. Males' ASIR was higher than females, while the gap narrowed over the years. A weakly positive correlation between ASIR of urolithiasis and SDI was also observed in this study.