Influence of socioeconomic disparities, temperature and humidity in kidney stone composition

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.

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Stone composition of renal stone formers from different global regions

Archivio Italiano di Urologia e Andrologia ◽

10.4081/aiua.2021.3.307 ◽

2021 ◽

Vol 93 (3) ◽

pp. 307-312

Author(s):

Adam Hali´nski ◽

Kamran Hassan Bhatti ◽

Luca Boeri ◽

Jonathan Cloutier ◽

Kaloyan Davidoff ◽

...

Keyword(s):

Uric Acid ◽

Calcium Phosphate ◽

Calcium Oxalate ◽

Urinary Stones ◽

Ureteral Stones ◽

Stone Analysis ◽

Stone Composition ◽

Stone Formers ◽

Cystine Stones ◽

Struvite Stones

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.

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Kidney Stone Composition in Various Country Around the World

10.21203/rs.3.rs-286555/v1 ◽

2021 ◽

Author(s):

Adam Halinski ◽

Elenko Popov ◽

Kamran Hassan Bhattikam ◽

Luca Boeri ◽

Jonathan Cloutier ◽

...

Keyword(s):

Uric Acid ◽

Calcium Phosphate ◽

Calcium Oxalate ◽

Urinary Stones ◽

Stone Composition ◽

Calcium Stones ◽

Uric Acid Stones ◽

The World ◽

Cystine Stones ◽

Struvite Stones

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.

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

10.1101/2021.11.24.21266803 ◽

2021 ◽

Author(s):

Sophie Natasha Vaggers ◽

Ross Warner ◽

Luke Forster ◽

Zubeir Ali ◽

Pallavi Pal ◽

...

Keyword(s):

Uric Acid ◽

Calcium Oxalate ◽

Local Population ◽

Ethnically Diverse ◽

Asian Population ◽

Black Population ◽

Stone Composition ◽

Black Patients ◽

Uric Acid Stones ◽

Significant Difference

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.

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Urinary stone composition analysis of 3684 patients in the eastern Shandong region of China

Journal of International Medical Research ◽

10.1177/0300060519887266 ◽

2019 ◽

Vol 48 (3) ◽

pp. 030006051988726

Author(s):

Xuebao Zhang ◽

Jiajia Ma ◽

Ning Wang ◽

Chunhua Lin

Keyword(s):

Uric Acid ◽

Calcium Oxalate ◽

Urinary Calculi ◽

High Rate ◽

Urinary Stones ◽

Composition Analysis ◽

Carbonate Apatite ◽

Stone Composition ◽

Calcium Oxalate Dihydrate ◽

Uric Acid Stones

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.

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Urinary stone composition analysis and clinical characterization of 1520 patients in central China

Scientific Reports ◽

10.1038/s41598-021-85723-3 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Daling Zhang ◽

Songchao Li ◽

Zhengguo Zhang ◽

Ningyang Li ◽

Xiang Yuan ◽

...

Keyword(s):

Calcium Oxalate ◽

Urinary Stone ◽

Geographic Region ◽

Central China ◽

Urinary Stones ◽

Composition Analysis ◽

Stone Composition ◽

Calcium Oxalate Stones ◽

Significant Difference ◽

Lower Urinary

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).

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Efficacy of Hounsfield Unit of CT in Prediction of the Chemical Composition of Urinary Stones

QJM ◽

10.1093/qjmed/hcab110.004 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Ahmed Salah Mahmoud Ahmed Shehata ◽

Mohamed Rafik El-Halaby ◽

Ahmed Mohamed Saafan

Keyword(s):

Uric Acid ◽

Chemical Composition ◽

Calcium Phosphate ◽

Calcium Oxalate ◽

Chemical Structure ◽

Urinary Calculi ◽

Hounsfield Unit ◽

Urinary Stones ◽

The Mean ◽

Struvite Stones

Abstract Objectives to make a reliable correlation between the chemical composition of the urinary calculi and its Hounsfield unit on CT scan, upon which we can depend on it for prediction of the type of the urinary calculi. The prediction of the chemical structure of the stone would help us to reach a more efficient therapeutic and prophylactic plan. Methods A retrospective study was performed by interpretation of the preoperative CT scans for patients who were presented by urinary stones. Identification of the chemical structure of the calculi was implemented using Fourier Transform Infrared Spectroscopy (FT-IR spectroscopy). The laboratory report revealed multiple types of stones either of pure or mixed composition. Afterwards, a comparison was done between Hounsfield units of the stones and the chemical structure. Results The chemical structure of the urinary stones revealed four pure types of stones (Uric acid, Calcium Oxalate, Struvite and Cystine) and two types of mixed stones (mixed calcium oxalate+ Uric, and mixed calcium oxalate+ calcium phosphate). Uric acid stone had a mean Hounsfield Unit (HU) density of428 ± 81, which was quite less than the other stones, followed by struvite stones with density ranging about 714 ± 38. Mixed calcium oxalate stones could be differentiated from other types of stones like uric acid, pure calcium oxalate and struvite stones by the Hounsfield unit of Computed Tomography (the mean Hounsfield Unit was 886 ± 139 and 1427 ± 152 for mixed calcium oxalate + uric stone and mixed calcium oxalate + calcium phosphate stones respectively). Moreover, pure calcium oxalate stones were easily differentiated from all other stones using the mean Hounsfield density as it was 1158 ± 83. It was challenging only when it was compared to cystine stones, as they were quiet similar to HU value (997 ± 14). The variation of Hounsfield values among the previously mentioned stones, was statistically significant (p < 0.001). Conclusion The study proved that the Hounsfield Unit of CT scanning is a convenient measure to predict the chemical structure of urinary calculi.

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Composition and Morphology of Nanocrystals in Urines of Lithogenic Patients and Healthy Persons

Bioinorganic Chemistry and Applications ◽

10.1155/2009/925297 ◽

2009 ◽

Vol 2009 ◽

pp. 1-7 ◽

Cited By ~ 1

Author(s):

Bao-Song Gui ◽

Rong Xie ◽

Xiu-Qiong Yao ◽

Mei-Ru Li ◽

Jian-Ming Ouyang

Keyword(s):

Uric Acid ◽

Calcium Oxalate ◽

Stone Formation ◽

Calcium Oxalate Monohydrate ◽

Urinary Stone ◽

Calcium Oxalate Dihydrate ◽

Transmission Electron ◽

Mean Size ◽

Healthy Persons ◽

Healthy Urine

The composition and morphology of nanocrystals in urines of healthy persons and lithogenic patients were comparatively investigated by means of X-ray diffraction (XRD) and transmission electron microscopy (TEM). It was shown that the main composition of urinary nanocrystals in healthy persons were calcium oxalate dihydrate (COD), uric acid, and ammonium magnesium phosphate (struvite). However, the main compositions of urinary nanocrystals in lithogenic patients were struvite,β-tricalcium phosphate, uric acid, COD, and calcium oxalate monohydrate (COM). According to the XRD data, the size of nanocrystals was calculated to be23∼72 nm in healthy urine and12∼118 nm in lithogenic urine by Scherer formula. TEM results showed that the nanocrystals in healthy urine were dispersive and uniform with a mean size of about 38 nm. In contrast, the nanocrystals in lithogenic urine were much aggregated with a mean size of about 55 nm. The results in this work indicated that the urinary stone formation may be prevented by diminishing the aggregation and the size differentiation of urinary nanocrystals by physical or chemical methods.

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Spectrum of pediatric urinary stone composition in North Western India: analysis at tertiary care center

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20194974 ◽

2019 ◽

Vol 7 (11) ◽

pp. 4102

Author(s):

Rama Kishan Saran ◽

Pawan Katti ◽

Kiran Mirdha ◽

Sanya Saran ◽

Rajendra Prasad Takhar

Keyword(s):

Uric Acid ◽

Calcium Phosphate ◽

Calcium Oxalate ◽

Pediatric Patients ◽

Dietary Habits ◽

Urinary Stone ◽

Urinary Stones ◽

Stone Composition ◽

Epidemiological Characteristics ◽

North Western

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.

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PROFIL ANALISIS BATU SALURAN KEMIH DI LABORATORIUM PATOLOGI KLINIK

INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY ◽

10.24293/ijcpml.v12i3.870 ◽

2018 ◽

Vol 12 (3) ◽

pp. 114 ◽

Cited By ~ 2

Author(s):

G. Ratu ◽

A. Badji

Keyword(s):

Uric Acid ◽

Calcium Oxalate ◽

Medical Records ◽

Age Groups ◽

Stone Analysis ◽

Stone Composition ◽

Cross Sectional ◽

Problematic Issue ◽

Urethral Stone ◽

Age And Sex

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.

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Time Changes in the Spectrum of Urinary Stone Composition: A Role for Climate Variations?

10.21203/rs.3.rs-41398/v2 ◽

2020 ◽

Author(s):

Alberto Trinchieri ◽

Alessandro Maletta ◽

Giovanni Simonelli ◽

Luca Boeri ◽

Elisa De Lorenzis ◽

...

Keyword(s):

Uric Acid ◽

Calcium Oxalate ◽

Calcium Oxalate Monohydrate ◽

Urinary Stone ◽

Northern Italy ◽

Urinary Stones ◽

Temperate Climate ◽

Stone Composition ◽

Statistical Institute ◽

Time Changes

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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