scholarly journals The relationship between ethnicity and stone composition in a large multi-ethnic London NHS Trust

Author(s):  
Sophie Natasha Vaggers ◽  
Ross Warner ◽  
Luke Forster ◽  
Zubeir Ali ◽  
Pallavi Pal ◽  
...  

Purpose Few studies have examined kidney stone composition of an ethnically diverse group living in the same location, we aimed to study this in an ethnically diverse NHS trust. Methods We reviewed all patients (n=312) with laboratory stone analysis and compared their ethnicity with their stone composition. Results Using a Chi Squared analysis there was no significant difference between stone composition in different ethnic groups (p=0.07). Uric acid stones were more common in the White-other group at 22.0% compared to 10.3% for White British, 5.2% for Asian and 9.52% for Black patients. Calcium oxalate stone were more common in the Asian population with 71.9% and Black population at 76.1%, compared with 56.7% in the White British population and 52.6% in the White-other population. Calcium phosphate stones were found commonly in the White British population (26.8%) compared to 18.6% for White-other, 16.7% for Asian and 9.5% for Black patients. Cystine and Struvite stones were found at low levels of between 0-3.4% in each group. Repeat stone formers with calcium oxalate, uric acid or cystine stones formed the same stone again 100.0% of the time. The odds for the Black population having a stone analysed (OR 0.62, CI 0.39-0.97, p=0.04) was significantly lower than the local population, and for the Asian population this was significantly higher (OR 1.31, CI1.05-1.62, p=0.01), Conclusion Uric acid stones are found more frequently in the White-other population and calcium oxalate stones are found more frequently in the Asian and black population. However, these results were not statistically significant. The odds ratio of having a stone was significantly higher in the Asian population and lower in the Black population.

2021 ◽  
Author(s):  
Adam Halinski ◽  
Elenko Popov ◽  
Kamran Hassan Bhattikam ◽  
Luca Boeri ◽  
Jonathan Cloutier ◽  
...  

Abstract To compare urinary stone composition patterns in different populations around the world in relation to the structure of their population, dietary habits, and climate. 1204 adult patients with urolithiasis and stone analysis was included . International websites were searched to obtain data. We observed 710(59%) patients with calcium oxalate, 31(1%) calcium phosphate, 161(13%) mixed calcium oxalate/calcium phosphate, 15(1%) carbapatite, 110(9%) uric acid, 7(<1%) urate, 100(9%) mixed uric acid/ calcium oxalate, 56(5%) struvite and 14(1%) cystine stones. Calcium stones were the most common in all countries (up to 91%) with the highest rates in Canada and China. Oxalate stones were more common than phosphate or mixed phosphate/oxalate stones except Egypt and India. The rate of uric acid stones, being higher in Egypt, India, Pakistan, Iraq, Poland, and Bulgaria. Struvite stones occurred in less than 5% except India (23%) and Pakistan (16%). Cystine stones occurred in 1%. The frequency of different types of urinary stones varies from country to country. Calcium stones are prevalent in all countries. Uric acid stones seems to depend mainly on climatic factors, being higher in countries with desert or tropical climates. Dietary patterns can also lead to an increase it. Struvite stones are decreasing in most countries.


Author(s):  
Tamara da Silva Cunha ◽  
Adrian Rodriguez ◽  
Ita Pfeferman Heilberg

Abstract Introduction: Large variations in demographic, economic and environmental factors might influence the worldwide distribution of urolithiasis, but scarce data are available concerning their associations with stone composition. We aimed to evaluate the frequency and composition of kidney stones and their associations with temperature, humidity, and human development index (HDI). Materials and Methods: A total of 1,158 stones from distinct patients (47±14 years old, male/female 2:1) were included. The mean annual temperature and relative humidity of each town were considered separately. Results: Calcium oxalate monohydrate (COM) was disclosed in 38.8% of patients, calcium oxalate dihydrate (COD) in 22.1%, mixed COD/apatite in 9.4%, pure apatite in 1.9%, brushite in 1.8%, struvite in 8.3%, pure uric acid in 11.1%, mixed uric acid/COM in 5.6%, and cystine/rare types in 0.8%. Mean HDI of all pooled cities was 0.780±0.03. However, people living in HDI<0.800 regions had twice the odds of having a struvite stone versus those living in HDI>0.800 (OR=2.14, 95% CI 1.11-4.11). Furthermore, a progressive increase in the struvite stones frequency from 4.5 to 22.8% was detected from HDI>0.800 through HDI<0.700. No significant difference for other stone types was disclosed. Separate logistic regression models assessed the association of each stone composition with gender, temperature, humidity and HDI as covariates. Conclusion: Patients living in low HDI areas are more prone to develop struvite stones, possibly due to lower access to healthcare. Temperature and humidity did not represent a specific risk factor for any stone type in the present sample.


2019 ◽  
Vol 48 (3) ◽  
pp. 030006051988726
Author(s):  
Xuebao Zhang ◽  
Jiajia Ma ◽  
Ning Wang ◽  
Chunhua Lin

Objective There has not been a study that analyzed the composition of urinary stones from patients in the eastern Shandong region of China. Thus, we explored the composition of urinary stones in the eastern Shandong region of China and discuss the clinical significance of the findings. Methods A total of 3684 urinary calculi from the eastern Shandong region were collected in our study. Compositions of the stones were analyzed using an Automatic Infrared Spectrum Analysis System (type LIIR-20). The results were verified through manual analysis of the spectrograms, which was accompanied by polarizing microscopy and chemical analysis if necessary. Results Among the 3684 specimens, there were 1767 single-component stones and 1917 mixed-component stones. According to the main components of the stones, the stones were divided into the following types: calcium oxalate monohydrate stones (1779, 48.3%), anhydrous uric acid stones (1105, 30.0%), carbonate apatite stones (590, 16.0%), ammonium magnesium phosphate hexahydrate stones (143, 3.9%), calcium oxalate dihydrate stones (36, 1.0%), and cystine stones (31, 0.8%). Conclusions There was a relatively high rate of uric acid stones in patients from the eastern Shandong region of China.


2020 ◽  
Vol 22 (1) ◽  
pp. 22-30
Author(s):  
Esteban Emiliani ◽  
Adrian Jara ◽  
Andres Koey Kanashiro

Background: Kidney stones are one of the oldest known and common diseases in the urinary tract with a prevalence that varies from 1% to 20%. Many phytotherapic and herbal medicines for kidney stones have been described for their treatment and prevention. Objective: The objective of this study is to perform a comprehensive review of several phytotherapic and herbal medicines published including clinical and animal studies. Results: Phytotherapy may influence the risk of recurrence in calcium oxalate and uric acid stones. The most solid evidence suggest that Phyllanthus niruri is one of the most studied components that appear to interfere with the calcium oxalate crystallization, reduced hyperoxaluria and hiperuricosuria and increased shock wave lithotripsy efficacy due to reduced crystallization without significant adverse effects, also Theobromine have shown to reduce the crystallization of uric acid in patients and appears to be a promising supplement to treat such stones. Conclusion: Many phytoterapic and herbal agents have been studies to treat and present urolithiasis, most of them only with studies of small number of patients or in animal models. Further randomized clinical trials are needed to evaluate the effect of these agents in kidney stones.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Daling Zhang ◽  
Songchao Li ◽  
Zhengguo Zhang ◽  
Ningyang Li ◽  
Xiang Yuan ◽  
...  

AbstractA total of 1520 patients with urinary stones from central China were collected and analysed by Fourier transform infrared spectroscopy between October 1, 2016 and December 31, 2019. For all patients, age, sex, comorbidities, stone location, laboratory examination and geographic region were collected. The most common stone component was calcium oxalate (77.5%), followed by calcium phosphate (8.7%), infection stone (7.6%), uric acid (UA) stone (5.3%)and cystine (0.9%). The males had more calcium oxalate stones (p < 0.001), while infection stone and cystine stones occurred more frequently in females (p < 0.001). The prevalence peak occurred at 41–60 years in both men and women. UA stones occurred frequently in patients with lower urinary pH (p < 0.001), while neutral urine or alkaline urine (p < 0.001) and urinary infection (p < 0.001) were more likely to be associated with infection stone stones. Patients with high levels of serum creatinine were more likely to develop UA stones (p < 0.001). The proportion of UA stones in diabetics was higher (p < 0.001), and the incidence of hypertension was higher in patients with UA stones (p < 0.001). Compared to the other types, more calcium oxalate stones were detected in the kidneys and ureters (p < 0.001), whereas struvite stones were more frequently observed in the lower urinary tract (p = 0.001). There was no significant difference in stone composition across the Qinling-Huaihe line in central China except UA stones, which were more frequently observed in patients south of the line (p < 0.001).


2021 ◽  
Vol 93 (3) ◽  
pp. 307-312
Author(s):  
Adam Hali´nski ◽  
Kamran Hassan Bhatti ◽  
Luca Boeri ◽  
Jonathan Cloutier ◽  
Kaloyan Davidoff ◽  
...  

Objective: To study urinary stone composition patterns in different populations around the world. Materials and methods: Data were collected by reviewing charts of 1204 adult patients of 10 countries with renal or ureteral stones (> 18 years) in whom a stone analysis was done and available. Any method of stone analysis was accepted, but the methodology had to be registered. Results: In total, we observed 710 (59%) patients with calcium oxalate, 31 (1%) with calcium phosphate, 161 (13%) with mixed calcium oxalate/calcium phosphate, 15 (1%) with carbapatite, 110 (9%) with uric acid, 7 (< 1%) with urate (ammonium or sodium), 100 (9%) with mixed with uric acid/ calcium oxalate, 56 (5%) with struvite and 14 (1%) with cystine stones. Calciumcontaining stones were the most common in all countries ranging from 43 to 91%. Oxalate stones were more common than phosphate or mixed phosphate/oxalate stones in most countries except Egypt and India. The rate of uric acid containing stones ranged from 4 to 34%, being higher in Egypt, India, Pakistan, Iraq, Poland and Bulgaria. Struvite stones occurred in less than 5% in all countries except India (23%) and Pakistan (16%). Cystine stones occurred in 1% of cases. Conclusions: The frequency of different types of urinary stones varies from country to country. Calcium-containing stones are prevalent in all countries. The frequency of uric acid containing stones seems to depend mainly on climatic factors, being higher in countries with desert or tropical climates. Dietary patterns can also lead to an increase in the frequency of uric acid containing stones in association with high obesity rates. Struvite stones are decreasing in most countries due to improved health conditions.


2014 ◽  
Vol 4 (4) ◽  
pp. 393-98
Author(s):  
Jayadevan Sreedharan ◽  
LJ John ◽  
HAM Aly Freeg ◽  
J Muttappallymyalil

Background   Ethnicity play a role in the occurrence of urinary stones, probably related to climatic, environmental and dietary factors in ethnic groups. The association between ethnicity, age, clinical profile, stone size with type of ureteric stones among males with urolithiasis was studied.   Materials and Methods Male patients (>18 years) with lower ureteral stones size <10mm attending outpatient department of Urology, at a private hospital, Ajman over a period of one year were included. Ethics approval was obtained from Institutional Ethics Committee. Data was retrieved from the case records which included socio-demographic variables (age, ethnicity), clinical profile (ureteric colic, duration of pain, other complaints), and laboratory investigations (type of stone, stone size). Descriptive and inferential statistics were performed with SPSS-20 and p values <0.05 considered significant. Results 185 male patients were included. Mean age was 41.5 (7.3) years, range (22-71) years. Out of the total, 81 (43.8%) patients were Asians, 81(43.8%) Arabs and 23 (12.4%) were of other ethnicity. Most patients (95.1%) presented with ureteric pain. 49 (26.5%) had family history of stone disease where calcium oxalate monohydrate and uric acid stones were common, with majority being first degree relation. Data on stone type was available for 90 patients; of which, 21 were calcium oxalate monohydrate, 33-calcium oxalate dehydrate, 24-uric acid and remaining 12 other form of stones. Average age for different types of stone was 38.3, 41.6, 39.4 and 42.8 years for calcium oxalate monohydrate, calcium oxalate dehydrate, uric acid and other types respectively. Conclusion Uric acid stones were more prevalent among Asians and calcium oxalate-dehydrate stones among Arabs. Future studies can be conducted among multiethnic population focusing on dietary pattern and stone analysis.DOI: http://dx.doi.org/10.3126/nje.v4i4.11359 Nepal Journal of Epidemiology 2014; 4(4):393-98


Author(s):  
Rama Kishan Saran ◽  
Pawan Katti ◽  
Kiran Mirdha ◽  
Sanya Saran ◽  
Rajendra Prasad Takhar

Background: Pediatric urolithiasis results in significant morbidity in later life. Incidence as well as site and chemical composition of calculi varies according to the changes in socio-economic conditions over time and the subsequent changes in dietary habits leading to a marked variation in the spectrum of urinary stone composition. To evaluate the spectrum of urinary stone composition in pediatric population from North-western India.Methods: This was a prospective observational study conducted between October 2013 and February 2019 which included pediatric patients with urolithiasis. Demographic and epidemiological characteristics including age, sex, geography, religion, socio-economic status, dietary habits were recorded. The location and sizes of stones were documented. The data was collected, analyzed and presented using summary statistics.Results: A total of 163 patients with urolithiasis were enrolled, of which 86 (53%) aged between 6 and 10 years, 49 (30%) aged between 11 and 14 years and 28 (17%) were aged between 0 and 5 years. The majority of patients were male (n=134; 82.21%). The most common location of the stone was urinary bladder (n=106; 65.03%) followed by kidney (n=33; 20.25%), urethra (n=16; 9.82%) and ureter (n=8; 4.91%). The upper tract (kidney and ureter) to the lower tract (bladder and urethra) stone ratio was 1:4. Stones with mixed composition were more than pure stones (73.62% versus 26.38%). The most common composition was the mixed stone of calcium oxalate, calcium phosphate and uric acid (n=36; 22.09%) followed by mixed stone of calcium oxalate monohydrate and dihydrate with uric acid (n=29; 17.79%), calcium oxalate and uric acid (n=25, 15.34%), calcium oxalate and calcium phosphate (n=20; 12.27%). Calcium oxalate was present in 80% of the stones, followed by uric acid in 7%, struvite in 6%, cystine in 3% and calcium phosphate in 2%.Conclusions: These results suggest that the prevalence of mixed stones with calcium oxalate as the predominant chemical component in the urinary stones of pediatric patients studied.


Author(s):  
G. Ratu ◽  
A. Badji

Urethral stones, or urolithiasis, is a pathologic and condition which is still a frequent problematic issue in the clinic, especially for itsrecurrence. This condition appears mostly in productive-age groups leading to affect their productivity. By stone analysis, the type andthe composition of concretes could be identified, so that the handling of patients could be arranged and its recurrence could be prevented.The study was carried to find out the distribution of urethral stone composition according to age and sex groups. A cross-sectional studyby means of medical records of 199 patients with urethral stone admitted to Dr. Wahidin Sudirohusodo Hospital was carried out duringMay 2002 to May 2004. Analysis was conducted microscopically and macroscopically by colorimetric and titrimetry. Urethral stoneswere found more in men 79.9% (159 of 199) than in women 20.1% (40 of 199). The peak prevalence of age between 31 to 45 yearswere 71.35%, the eldest being 86 years while the youngest was 2 years. The mostly found composition of calcium-oxalate was 87.4%,brushitt was 45.2%, and uric acid was 32.2%. The prevalence of urethral stones was still high, mostly found in 31 to 45 years of agegroup, affecting more men than women, and calcium oxalate showed the highest frequency.


2020 ◽  
Author(s):  
Alberto Trinchieri ◽  
Alessandro Maletta ◽  
Giovanni Simonelli ◽  
Luca Boeri ◽  
Elisa De Lorenzis ◽  
...  

Abstract Introduction: An increase of the frequency of uric acid urinary stones compared to calcium-containing ones has been recently described. This study was aimed at assessing the frequency of different types of urinary stones in the population of northern Italy in the period 2016-18 compared to 2001-2003. Materials and Methods: Analyses by infrared spectroscopy of 1007 stones endoscopically removed at two institutions in the area of Milan (Northern Italy) were retrospectively considered. Stones were classified as calcium oxalate monohydrate (COM) and dihydrate (COD), mixed uric acid/calcium oxalate (UC); uric acid (UA), struvite (ST); apatite (CAP); mixed calcium oxalate / apatite (CAPOX); others. The patients were divided into two groups: 2001-2003 and 2016-2018. The average temperature values of the region over the two time periods were obtained by the national statistical institute. Results: The average age of the 2001-2003 group (45.8+/-15.4 years) was significantly lower than the average age of the 2016-18 group (57.9+/-14.8) (0.000). M / F ratio was similar in the two groups: 119 / 69 (1:0.58) in 2001-2003 MI and 527 / 292 (1:0.55) in 2016-18 (p = 0.862). COM stones tended to more frequent in 2016-18 group than in 2001-03. COD stones were significantly more frequent in 2001-03 than in 2016-18. ST stone frequency was increased from 2001-03 to 2016-18. No increase of uric acid containing stones was observed in 2016-18. Results were confirmed after adjustment by age. Averages annual regional temperatures increased from 14° C to 15.4° C during the two observation periods. Conclusions: No increase of UA stones was observed, probably due to the limited impact of the global warming in our temperate climate.


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