A DECADE OF UROLITHIASIS IN BRAZIL (2014–2024): CLINICAL BURDEN, REGIONAL VULNERABILITIES, AND ECONOMIC IMPACT ON THE BRAZILIAN UNIFIED HEALTH SYSTEM (SUS

Urolithiasis (urinary stone disease) is a highly prevalent and recurrent urological condition characterized by the formation of solid concretions in the urinary tract. Its impact is substantial, causing renal colic, risk of sepsis, and kidney damage, and often requiring complex surgical interventions. The etiology is multifactorial, and there has been a global rise in incidence and prevalence driven by social and behavioral changes such as obesity and physical inactivity, imposing a considerable economic burden on health systems. In Brazil—where climatic variation and unequal access to care coexist—it is essential to investigate the epidemiological profile and economic impact to guide effective public policies.

We conducted a descriptive, retrospective study with a quantitative approach, assessing hospitalizations for urolithiasis by region of Brazil from 2014 to 2024. Data were extracted from the Hospital Information System (SIH) of the Unified Health System (SUS), Brazil’s public health system. Inclusion variables comprised the number of hospitalizations, hospitalization costs, sex, age group, and race/skin color; absolute and relative frequencies were analyzed in Microsoft Excel. Records with incomplete or blank information were excluded.

Between 2014 and 2024, there were 988,149 hospitalizations for urolithiasis, increasing from 72,073 to 144,433 cases—an overall rise of 100.4% over the decade, with an average annual increase of 7.2%. This pattern reflects an acceleration of the globally reported upward trend in prevalence and incidence. For example, studies by Wang’s group in China reported increasing urolithiasis prevalence across 1991–2000, 2001–2010, and 2011–2016 at 5.95%, 8.86%, and 10.63%, respectively, with similar figures documented in Taiwan (9.6%). In Brazil, the sharpest growth occurred from 2020 to 2024 (+83.6%), coinciding with the COVID-19 pandemic, a period marked worldwide by reduced access to health services, decreased physical activity, and higher consumption of ultra-processed foods. The Southeast region accounted for the largest share of hospitalizations (46.4%), mirroring global patterns wherein more urbanized regions tend to show higher absolute numbers due to population density, greater access to diagnostics, and more industrialized dietary habits. By race/skin color, most hospitalizations occurred among White (45%) and Pardo/mixed-race (35%) individuals; these proportions do not necessarily imply higher individual risk, as they are closely tied to population distribution. By sex, the distribution was largely balanced, with a slight male predominance (50.4%), a trend observed in several countries and attributed to biopsychosocial factors. The most affected age groups were 40–49 years (22.4%) and 30–39 years (20.7%), corresponding to the working-age population and underscoring the economic and social impact of urolithiasis, including productivity losses, higher absenteeism, and increased costs for the health system. Total spending on urolithiasis-related hospitalizations in the public system over the period was approximately $140.4 million, with a marked increase from 2020 onward. This amount represents a material share of resources devoted to nephrological care and reinforces the need for coordinated international efforts to strengthen prevention, early diagnosis, and outpatient management strategies.

The Brazilian data echo a scenario that extends beyond national borders. As in many countries, rising urolithiasis is linked to ongoing urbanization, dietary shifts, and the growing impact of metabolic diseases in daily life. The trend reflects not only numbers but lives affected by an increasingly global problem that demands shared attention among nations. Investment in prevention, health education, and equitable access to diagnostics is essential to reduce individual suffering and the collective burden of disease, elevating kidney health as a global priority.