Kidney Stone Disease of Non Gouty Origin in 264 Popes (34-2005 AD): A Historical Review

Abstract

A total of 11 non-gouty popes out of 264 (4.1%) died of kidney stones (very probably calcium stones) between the years 34-2005 AD. The prevalence of kidney stones was lower than expected on the basis of recent population-based data. The discrepancy might be due to the changing nutritional habits. Causes of death included acute kidney injury, chronic kidney disease, and stroke. The disease was highly recurrent in 9 of 11 (88.1%). Recurrences were observed 1 to 30 years after the first attack. Mean age at death was 63.1 years, much shorter than expected in popes. Clinically recurrent back-flank-groin pain emerged as a hallmark indicator of kidney stones in the narratives. It was sometimes associated with fever, hematuria, purulent urine and/or frequent urination and dysuria. Some popes were obese, sedentary, voracious and wine drinkers; others were lean, took long walks, ate frugal meals and practiced restraint when it came to drinking alcohol. They were cured with bed rest, diets, donkey milk, mineral waters, decongestant, purgatives, thermal baths, blood-letting, and surgery.

The Dropsy of Popes (1555–1978): A Bad Prognostic Sign Foreboding of Death

“…Thus, the latter group will experience morbidity and mortality of the disease where rich, well-educated people can achieve prevention. The theory also explains why gout disappeared from the Vatican palaces but increased in the general population (De Santo et al, 2021a , b , 2022 ). We are certain that the use of salt in the papal kitchen is no longer what it once was in the past.…”

“…Of note is the principal cause of kidney disease as obstructive nephropathy due to gout or stones. It has been shown that many popes suffered of kidney stone disease of gouty and non gouty origin, the former was more frequent (De Santo et al, 2021a , b ), however the last gouty pope was Pius X who died in 1914. Thus in the last hundred year no pope was gouty indicating that gout is no longer a diseases of wealthy people.…”

“…Nineteen of them were older than 80 years at death. Popes represent a special category of medical subjects whose health status has been closely monitored and chronicled because of their uniquely important position in the history of their times(De Santo et al, 2020 , 2021a , 2021b ). Papal dropsies, their etiology, and the prognostic value of edema were examined in the papal histories from Boniface VIII to John Paul II, a span of over seven centuries (1294–2005).…”