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This research aims to identify factors influencing the age of onset in nephrolithiasis to improve prevention strategies.

May 10, 2026Research and Reports in Urology0 citationsOpen Access

When Stones Begin: Age of Onset Reveals the Systemic Metabolic Nature of Nephrolithiasis

AAAdel AlrabadiUniversity of Jordan BABaha Aldeen AlshraidehUniversity of Jordan EAEnsaf AlmomaniAl-Balqa Applied University

Key Points

This research aims to identify factors influencing the age of onset in nephrolithiasis to improve prevention strategies.
Included 546 patients with confirmed nephrolithiasis stratified into early-onset (< 45 years) and late-onset (≥ 45 years) groups.
Collected sociodemographic, clinical, urinalysis, and biochemical data for analysis.
Employed Chi-square tests and multivariable linear regression to evaluate associations.
Early-onset disease was present in 57.1% of cases.
Higher body mass index, smoking, and comorbidities were significantly associated with younger age of onset (p < 0.001).
Independent predictors of earlier onset included hypertension (β = −0.374) and diabetes (β = −0.381) with statistical significance (p < 0.05).

Abstract

Background: Kidney stone disease is a common urological condition with a rising worldwide incidence. Although multiple metabolic and lifestyle risk factors have been identified, determinants influencing the age at which symptoms begin remain poorly defined. Understanding factors associated with earlier disease presentation may improve prevention strategies. Methods: This observational cohort study included 546 patients with confirmed nephrolithiasis. Participants were stratified into early-onset (< 45 years) and late-onset (≥ 45 years) groups. Sociodemographic, lifestyle, clinical, urinalysis, and biochemical data were collected. Group comparisons were performed using the Chi-square test. Multivariable linear regression analyses evaluated independent associations between age of onset and clinical, laboratory, and hormonal variables. Statistical significance was set at p < 0.05. Results: Early-onset disease accounted for 57.1% of cases. Higher body mass index, smoking, functional status, employment, and education level were significantly associated with age of onset ( p < 0.001). Several comorbidities, including hypertension, diabetes mellitus, cardiovascular disease, renal impairment, gout, gallstones, and renal cell carcinoma, were inversely associated with age of onset. Regression analyses confirmed younger onset as an independent predictor of hypertension (β = − 0.374), diabetes (β = − 0.381), heart disease (β = − 0.253), renal impairment (β = − 0.110), gout (β = − 0.120), and gallstones (β = − 0.148) ( p < 0.05). Urinalysis parameters showed limited associations, with urinary crystals as the only significant predictor ( p = 0.012). Elevated serum urea and calcium were independently associated with earlier onsets. Conclusion: Early-onset nephrolithiasis is strongly associated with metabolic and cardiovascular comorbidities and specific biochemical abnormalities. Age of onset may serve as a clinically meaningful marker for risk stratification and targeted preventive interventions. Keywords: nephrolithiasis, age of onset, cardiometabolic comorbidities, biochemical risk factors, risk stratification

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