Prevalence of urolithiasis in the autonomous city of Buenos Aires, Argentina

The association between non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) and prevalence of urinary stones in US adults: a cross-sectional NHANES study

BACKGROUND

This study examines the association between the non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) and urinary stones in American adults.

METHODS

We conducted a cross-sectional study utilizing the 2007-2018 National Health and Nutrition Examination Survey (NHANES) data set. The prevalence of urinary stones was determined based on patient-reported experiences of renal colic. We converted NHHR to natural logarithm (ln-NHHR) to align it better with our statistical analyses. Our analysis methods included weighted multivariate logistic regression, generalized additive model (GAM), and application of smoothed curves to better elucidate the association between ln-NHHR and the prevalence of urinary stones. In addition, we conducted subgroup analyses and employed multiple imputation for sensitivity analyses.

RESULTS

This study involved a total of 30,903 participants, with a 9.97% prevalence of urinary stones and reported colic experience. Elevated ln-NHHR levels were linked with a higher likelihood of urinary stones (OR = 1.20, 95% CI 1.07-1.35). Smooth curve fitting revealed an inverted U-shaped relationship, pinpointing a significant increase in urinary stone risk at ln-NHHR levels below 1.43 (OR = 1.40, 95% CI 1.19-1.64, p < 0.001). Notably, this correlation was stronger among Non-Hispanic Whites and those married or living with a partner. Multiple imputation analyses strengthened the confidence in our results.

CONCLUSIONS

Our findings suggest a reverse U-shaped association between urinary stone occurrence and NHHR level, with a positive association at ln-NHHR < 1.43. This correlation was more pronounced in the Non-Hispanic White population and among those married or living with a partner.

Global Trends in Kidney Stone Awareness: A Time Series Analysis from 2004-2023

BACKGROUND

Despite the prevalence and incidence of kidney stones progressively increasing worldwide, public awareness of this condition remains unclear. Understanding trends of awareness can assist healthcare professionals and policymakers in planning and implementing targeted health interventions. This study investigated online search interest in "kidney stone" by analyzing Google Trends, focusing on stationarity of the trends and predicting future trends.

METHODS

We performed time series analysis on worldwide Google monthly search data from January 2004 to November 2023. The Augmented Dickey-Fuller (ADF) test was used to assess the stationarity of the data, with a p-value below 0.05 indicating stationarity. Time series forecasting was performed using the autoregressive integrated moving average to predict future trends.

RESULTS

The highest search interest for "kidney stone" (score 100) was in August 2022, while the lowest was in December 2007 (score 36). As of November 2023, search interest remained high, at 92. The ADF test was significant (p = 0.023), confirming data stationarity. The time series forecasting projected continued high public interest, likely reflecting ongoing concern and awareness. Notably, diverse regions such as Iran, the Philippines, Ecuador, the United States, and Nepal showed significant interest, suggesting widespread awareness of nephrolithiasis.

CONCLUSION

This study highlighted that "kidney stone" is a consistently relevant health issue globally. The increase and stationarity of search trends, the forecasted sustained interest, and diverse regional interest emphasize the need for collaborative research and educational initiatives. This study's analysis serves as a valuable tool for shaping future healthcare policies and research directions in addressing nephrolithiasis related health challenges.

Nonpapillary Prone Endoscopic Combined Intrarenal Surgery (ECIRS): Five-Year Experience and Outcomes from a High-Volume Center

Endoscopic combined intrarenal surgery (ECIRS) provides simultaneous retrograde and percutaneous access to the upper urinary tract. The purpose of this study is to present revised data, tips and tricks, and technique modifications arising from our five-year experience with ECIRS. The data of 62 patients who underwent nonpapillary prone ECIRS from January 2019 to November 2023 were prospectively collected. All cases were performed in the prone position. Inclusion criteria were complex stone cases with stones in multiple calyces requiring either multiple accesses or multiple sessions to achieve stone-free status. Patients' mean age was 54.4 ± 12.39 years, while the mean stone size was 39.03 ± 13.93 mm. The mean operative time was 51.23 ± 17.75 min. Primary and final stone-free rates were 83.8% and 90.3%, respectively. In total, nine patients presented with postoperative complications, which were all Grade II ones. The holmium-YAG laser type during retrograde lithotripsy was associated with significantly shorter operative times compared to the thulium fiber laser. Nonpapillary prone ECIRS is a feasible, safe, and efficient approach for patients with specific stone and anatomy characteristics. The implementation of more, higher-evidence studies is of utmost importance so that safer conclusions can be drawn.

Nur MA, Mohamed FY, Mohamud AK, Hassan J. The prevalence of urolithiasis in subjects undergoing computer tomography in selected referral diagnostic centers in Mogadishu, Somalia

Introduction and objectives

Somalia was predicted to be in the global stone belt with high urolithiasis prevalence. We aimed to determine the prevalence of urolithiasis and their demographic and computer tomography (CT) characteristics among subjects under CT scans in Mogadishu, Somalia. Materials and Methods: From March 2014 to November 2022, a total of 7,276 patients who underwent an abdominopelvic non-contrast CT scan for various indications were retrospectively reviewed. The mean age was 45.6 years with a standard deviation of 21.1 (range, 0.2-110 years). Patients were subdivided into two categories: adults (≥18 years) and pediatric (≤17 years).

Results

Of the 7,276 patients, 1,075 (14.8%) were diagnosed with urolithiasis. Among those with urolithiasis, 702 (65.3%) were male patients, and 373 (34.7%) were female patients. Among them, adults accounted for 92.7%, while children were 7.3%. Renal stones (nephrolithiasis) were the most common, representing 57% followed by ureteric stones at 35.5%, making upper urinary stones 92.5%. Approximately 70 patients (6.5%) had bladder stones; of these, 26 of them (37%) were accompanied by benign prostatic hyperplasia (BPH). There were 10 urethral stones (0.9%) recorded in the study, all were found in male patients, 8 localized in prostatic urethra, and 2 in the bulbar urethra. The overall mean stone size was 13.2 mm, and 60% of them ranged from 5 to 22 mm. Only 24% of the patients were asymptomatic. Single stones were almost 70%, while staghorn calculi were 8.2%. More than 60% of the patients with urolithiasis showed some degree of hydronephrosis ranging between mild to severe.

Conclusion

A CT scan-based urolithiasis prevalence indicates 14.8% in Mogadishu, Somalia, and these results are consistent with the probability calculation of the weights-of-evidence (WofE) methodology based on several risk factors including temperature, climate change, mineral deposit, drinking water quality, and distribution of carbonated rocks. Considering the high prevalence of the disease, Somalia needs to invest more in prevention and treatment facilities while also training urologists that are capable of utilizing minimally invasive techniques in the country.

Association between sleep quality and urolithiasis among general population in Western China: a cross-sectional study

Background

Growing number of studies have evidently shown that sleep disorders are associated with the recently increased risk of various diseases in general human population. However, the relationship between sleep quality and urolithiasis condition in humans is still unclear. The present study explored the relationship between quality of sleep and urolithiasis in Chinese population of population, western China and hence investigated the effects of sleep quality on urolithiasis disease.

Methods

A cross-sectional analysis was performed using data from the West China Natural Population Cohort Study (WCNPCS). The data was collected between May 2019 and June 2021. This study evaluated the association between the sleep quality and urolithiasis. The sleep quality was assessed using the Chinese version of the Pittsburgh Sleep Quality Index (PSQI) whereas urolithiasis, as the outcome was a binary variable. Multivariable logistic regression models that adjust the sociodemographic characteristics and health-related factors were used to assess the association between sleep quality and urolithiasis. Interaction was tested in prespecified subgroup of interest.

Results

After adjusting a series of confounding variables, the Pittsburgh Sleep Quality Index scores were found to have a significant positive correlation with the prevalence of urolithiasis (OR: 1.178; 95% CI = 1.083–1.282; p < 0.001). The risk of urolithiasis was significantly increased with an elevation of the component Pittsburgh Sleep Quality Index score in sleep latency, sleep duration, habitual sleep efficiency, and daytime dysfunction.

Conclusions

It was evident that there is an association between sleep quality and prevalence of renal stones in natural population in western China regions. Poor sleep quality is related to urolithiasis. The findings of the current study hence highlighted the need for future public health guidelines to develop detailed strategies for improving sleep quality.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-14187-5.

Prevalence of urolithiasis in Sarawak and associated risk factors: An ultrasonagraphy-based cross-sectional study

Objective

The aim of this research is to study the prevalence of urolithiasis among the population of Sarawak Malaysia and the associated risk factors.

Patients and Methods

A survey was conducted among individuals aged ≥18 years age in three primary health care clinics in the main cities of Sarawak from March 2019 to March 2020. Participants underwent face-to-face interview using a predesigned and standardised questionnaire. Details on demographic data, comorbidities, dietary variables and lifestyle were collected. Ultrasonographic examination of the kidney, ureter and bladder was performed followed by blood and urine sampling. Prevalence was defined as the proportion of participants with kidney stones, and univariate logistic regression was used to estimate the associated factors.

Results

A total of 1087 participants (486 male, 601 female) completed the questionnaire. Ultrasonographic examination and laboratory investigation were carried out, with an overall response rate of 98.8%. The prevalence of ultrasonographic proven urolithiasis in the sample studied was 4.04%. The mean age of patients with urolithiasis was 50.05 (SD 14.6, range 18-89), and the male to female ratio was 1.2: 1. Univariate analysis showed that odd ratio of personal history of urolithiasis (0.16, p:0.00), salty food intake (0.39, p:0.02), family history of urolithiasis (0.39, p:0.01), and hypertension (1.77, p:0.04) was significantly associated with a greater risk of urolithiasis.

Conclusion

The prevalence of urolithiasis in this study population is 4.04%. It affects males and females equally; 61.4% are in the age group of 25-64 years. Hypertension, high salt diet, personal history of urolithiasis and family history of urolithiasis are significant risk factors.

Probiotics in the Prevention of the Calcium Oxalate Urolithiasis

Nephrolithiasis ranks third among urological diseases in terms of prevalence, making up about 15% of cases. The continued increase in the incidence of nephrolithiasis is most probably due to changes in eating habits (high protein, sodium, and sugar diets) and lifestyle (reduced physical activity) in all developed countries. Some 80% of all kidney stones cases are oxalate urolithiasis, which is also characterized by the highest risk of recurrence. Frequent relapses of nephrolithiasis contribute to severe complications and high treatment costs. Unfortunately, there is no known effective way to prevent urolithiasis at present. In cases of diet-related urolithiasis, dietary changes may prevent recurrence. However, in some patients, the condition is unrelated to diet; in such cases, there is evidence to support the use of stone-related medications. Interestingly, a growing body of evidence indicates the potential of the microbiome to reduce the risk of developing renal colic. Previous studies have primarily focused on the use of Oxalobacterformigenes in patients with urolithiasis. Unfortunately, this bacterium is not an ideal probiotic due to its antibiotic sensitivity and low pH. Therefore, subsequent studies sought to find bacteria which are capable of oxalate degradation, focusing on well-known probiotics including Lactobacillus and Bifidobacterium strains, Eubacterium lentum, Enterococcus faecalis, and Escherichia coli.

Evaluating the understanding about kidney stones among adults in the United Arab Emirates

Objectives

The prevalence of kidney stones is increasing worldwide. Multiple risk factors are believed to contribute to the development of kidney stones such as lifestyle, diet, and global warming. In the United Arab Emirates (UAE), there has been limited research exploring the prevalence and risk factors of kidney stones. This study attempts to assess the understanding and prevalence of kidney stones among adults in the UAE.

Methods

In this cross-sectional study, data were collected using a self-administered questionnaire, distributed among 515 participants (20–49 years old) from Abu Dhabi, Dubai, Ajman, and Sharjah states. IBM SPSS version 25 was used for data analysis.

Results

The mean of knowledge score was 56.4% (n = 500). There was no correlation between the knowledge of those who had experienced kidney stones and those who did not. Furthermore, a family history of kidney stones increased the risk of developing stones by 2.27 times. Among participants reporting signs, symptoms, diagnosis, and the management of kidney stones, the knowledge and understanding about kidney stones was high. However, the perceptions of the same cohort about dietary precautions were limited. While analysing the sources of knowledge, the Internet and mass media were twice as important as physicians in educating the population.

Conclusion

This study shows that the study cohort from the UAE population was aware of certain aspects of kidney stones but was quite naïve about its consequential risk factors. This highlights the importance of promoting education about kidney stones through health campaigns.

Percutaneous Nephrolithotomy Can Reduce the Incidence of Sepsis Compared with Flexible Ureteroscopy in Treating Solitary Proximal Ureteral Stone Patients with Positive Urine Culture

Background

Sepsis is a potentially lethal complication for both flexible ureteroscopy (fURS) and percutaneous nephrolithotomy (PCNL). This study is aimed at comparing the sepsis rate after fURS and PCNL and the risk factors for sepsis in patients with solitary proximal ureteral stone.

Methods

We reviewed the data of patients with calculi between 10 mm to 20 mm who underwent fURS or PCNL surgery from Tongji Hospital's database. A total of 910 patients were eligible with 412 fURS cases and 498 PCNL cases. We used univariate analysis and multivariate logistic regression analysis to identify the risk factors for sepsis. Subgroup analysis was performed using logistic regression analysis.

Results

In the cohort, 27 (6.6%) and 19 (3.8%) patients developed sepsis after fURS and PCNL, respectively. Multivariate analysis shows that the risk factors for sepsis are fURS (OR = 3.160, P = 0.004), serum WBC ≥ 10,000 cells/μL (OR = 3.490, P = 0.008), albumin − globulin ratio < 1.2 (OR = 2.192, P = 0.029), positive urine culture (OR = 6.145, P < 0.001), and prolonged operation time (OR = 1.010, P = 0.046). Subgroup analysis was conducted using potential risk factors: stone size, serum WBC, urine culture, and albumin-globulin ratio (AGR). In subgroup of positive urine culture, patients were more likely to develop sepsis after fURS than PCNL.

Conclusions

PCNL may be a better choice than fURS to reduce postoperative sepsis, especially for patients with positive urine culture.

Water for preventing urinary stones

BACKGROUND

Urinary stone disease is a common condition characterised by increasing prevalence and high rates of recurrence. Observational studies have reported that increased water intake played a role in the prevention of urinary stone formation but with limited strength of evidence.

OBJECTIVES

To compare the effects of increased water intake with standard water intake for the prevention of urinary stone formation in participants with or without a history of urinary stones.

SEARCH METHODS

We performed a systematic search of PubMed (MEDLINE), EMBASE (Ovid) and the Cochrane Library to 15 October 2019. We handsearched review articles, clinical trial registries, and reference lists of retrieved articles. We did not apply any restrictions to publication language or publication status.

SELECTION CRITERIA

We included randomised controlled trials (RCTs) and quasi-RCTs looking at the benefits and harms of increased water intake versus standard water intake for the prevention of urinary stone formation in participants with or without a history of urinary stones.

DATA COLLECTION AND ANALYSIS

We used standard methodological procedures expected by Cochrane. Two review authors independently extracted data and assessed the risk of bias of included studies. We pooled dichotomous outcomes (e.g. incidence/recurrence rate of urinary stones; adverse events) using risk ratios (RRs) with 95% confidence intervals (CIs). We calculated hazard ratio (HRs) and corresponding 95% CIs to assess the intervention effect for time-to-event outcomes. We assessed the certainty of the evidence by using the GRADE criteria.

MAIN RESULTS

Our search identified no RCTs investigating the role of increased water intake for the prevention of urinary stone formation in participants with no history of urinary stones (primary prevention). We found one RCT assessing the effects of increased water intake versus standard water intake for the prevention of urinary stone formation in people with a history of urinary stones (secondary prevention). This trial randomised 220 participants (110 participants in the intervention group with increased water intake and 110 in the control group with standard water intake). Increased water intake was defined as achieving a urine volume of at least 2.0 L per day by drinking water. Based on this study, increased water intake may decrease stone recurrences (RR 0.45, 95% CI 0.24 to 0.84; 199 participants; low-certainty evidence); this corresponds to 149 fewer (43 fewer to 205 fewer) stone recurrences per 1000 participants with 270 stone recurrence per 1000 participants over five years in the control group. Increased water intake may also prolong the time to urinary stone recurrence compared to standard water intake (HR 0.40, 95% CI 0.20 to 0.79; 199 participants; low-certainty evidence); based on a stone recurrence rate of 270 per 1000 participants over five years, this corresponds to 152 fewer (209 fewer to 50 fewer) recurrences per 1000 participants. For both outcomes we downgraded the certainty of evidence for study limitations and imprecision. We found no evidence for the outcome of adverse events AUTHORS' CONCLUSIONS: We found no RCT evidence on the role of increased water intake for primary prevention of urinary stones. For secondary prevention, increased water intake achieving a urine volume of at least 2.0 L/day may reduce urinary stone recurrence and prolong time to recurrence for people with a history of urinary stone disease. However, our confidence in these findings is limited. We did not find evidence for adverse events.

Comorbidities in Argentine patients with axial spondyloarthritis: Is nephrolithiasis associated with this disease?

OBJECTIVE

The objective of this study was to compare the frequency of comorbidities among patients with ax-SpA in the general population and to evaluate the impact of these comorbidities on the functional status and quality of life.

METHODS

Patients with ax-SpA fulfilling the modified New York 1984 criteria for Ankylosing Spondylitis (AS) and/or Assessment of SpondyloArthritis International Society (ASAS) 2009 criteria for patients with ax-SpA belonging to the ESPAXIA cohort ("Estudio de eSPondiloartritis Axial Irep Argentina") were included. Data regarding sociodemographics, comorbidities, and disease characteristics were recorded. Statistical analysis included descriptive statistics using the student t-test, Chi-square, and Fisher's exact test. Multiple logistic regression analysis was performed. A p value <0.05 was considered significant.

RESULTS

In total, 86 patients were included, 80% were males with a median age of 46 years (interquartile range [IQR]: 32-58) and a median disease duration of 19 years (IQR: 13-31). The most frequent comorbidities reported were hypertension (26.7%), gastritis (25.6%), dyslipidemia (24.4%), gallstone (12.8%), nephrolithiasis (11.6%), anemia (10.5%), hypothyroidism (7%), and type 2 diabetes (6%). The prevalence of these comorbidities in patients with ax-SpA was similar to that observed in the general population, with the exception of a higher frequency of nephrolithiasis among patients with ax-SpA (11.6% in ax-SpA vs 3.96% in the general population). We further categorized the study population into three groups: patients with no comorbidities, those with 1 or 2 comorbidities, and those with ≥3 comorbidities. The presence of ≥3 comorbidities was associated with older age, longer disease duration, worse disease activity, functional status, and quality of life as compared with the patients without comorbidities. In multivariate analysis, older age was the only variable independently associated with the presence of comorbidities.

CONCLUSION

The frequency of comorbidities in the ax-SpA cohort was high, and the only variable associated with a higher prevalence of comorbidities was older age. Nephrolithiasis was more frequent in the patients with ax-SpA than that reported in the general population.

Retrograde intrarenal surgery: An expanding role in treatment of urolithiasis

During the past 3 decades, the surgical management of kidney stones has undergone many technological advances and one is the development of the flexible ureteroscopy. The development of this instrument as well as ancillary equipment such as baskets, graspers, and others, and improvements in lithotripsy with Holmium: YAG laser have led to expand its indications with diagnostic and therapeutic management of medical issues of the upper urinary tract such as urolithiasis and urothelial tumors. The objective of this review is to describe its indications and results in the different scenarios for the treatment of urinary stones.

Evaluation of Guidelines for Surgical Management of Urolithiasis

PURPOSE

Many urological societies have provided evidence-based guidelines to help the urologist make therapeutic choices. However, the recommendations in these guidelines may be heterogeneous because they were developed using various methods. The objective of this study was to review key guidelines on the surgical management of urinary stones to provide practical guidance for clinical application.

MATERIALS AND METHODS

Guidelines on urolithiasis from all international urological societies were searched through the society websites. A search on PubMed® and Medline® restricted to publications in English was also performed for guidelines published between January 1, 2010 and July 1, 2017. Only the latest versions of guidelines containing an evaluation of the level of evidence and the grade of recommendation were included in the final analysis. All recommendations on surgical stone management and recommended techniques for each surgical modality were included. The AGREE II (Appraisal of Guidelines for Research and Evaluation II) instrument was used to assess the quality of the included guidelines.

RESULTS

Three international guidelines were included in analysis, including those of AUA (American Urological Association)/ES (Endourological Society), EAU (European Association of Urology) and SIU (Société Internationale d'Urologie)/ICUD (International Consultation on Urological Diseases). We highlighted the heterogeneity in the level of evidence and the grade of recommendation which arose due to the different methods of evaluations that had been adopted. Despite this our review highlighted the considerable similarities among the guidelines. In certain specific situations for which no good evidence was available the recommendations could only be based on expert opinion.

CONCLUSIONS

An option to provide clear guidance to the urologist might be to combine these international guidelines into one to reduce confusion about the surgical management of urolithiasis.

Epidemiology of stone disease across the world

Nephrolithiasis is a highly prevalent disease worldwide with rates ranging from 7 to 13% in North America, 5-9% in Europe, and 1-5% in Asia. Due to high rates of new and recurrent stones, management of stones is expensive and the disease has a high level of acute and chronic morbidity. The goal of this study is to review the epidemiology of stone disease in order to improve patient care. A review of the literature was conducted through a search on Pubmed^®, Medline^®, and Google Scholar^®. This review was presented and peer-reviewed at the 3rd International Consultation on Stone Disease during the 2014 Société Internationale d'Urologie Congress in Glasgow. It represents an update of the 2008 consensus document based on expert opinion of the most relevant studies. There has been a rising incidence in stone disease throughout the world with a narrowing of the gender gap. Increased stone prevalence has been attributed to population growth and increases in obesity and diabetes. General dietary recommendations of increased fluid, decreased salt, and moderate intake of protein have not changed. However, specific recommended values have either changed or are more frequently reported. Geography and environment influenced the likelihood of stone disease and more information is needed regarding stone disease in a large portion of the world including Asia and Africa. Randomized controlled studies are lacking but are necessary to improve recommendations regarding diet and fluid intake. Understanding the impact of associated conditions that are rapidly increasing will improve the prevention of stone disease.

Inter-annual variability of urolithiasis epidemic from semi-arid part of Deccan Volcanic Province, India: climatic and hydrogeochemical perspectives

Semi-arid Karha basin from Deccan Volcanic Province, India was investigated for inter-annual variability of urolithiasis epidemic. The number of reported urolith patient, weather station data and groundwater quality results was used to assess impact of geoenvironment on urolithiasis. Data of 7081 urolith patient were processed for epidemiological study. Gender class, age group, year-wise cases and urolith type were studied in epidemiology. Rainfall, temperature, pan evaporation and sunshine hours were used to correlate urolithiasis. Further, average values of groundwater parameters were correlated with the number of urolith episodes. A total of 52 urolith samples were collected from hospitals and analysed using FTIR technique to identify dominant urolith type in study area. Result shows that male population is more prone, age group of 20-40 is more susceptible and calcium oxalate uroliths are dominant in study area. Year-wise distribution revealed that there is steady increase in urolithiasis with inflation in drought years. In climatic parameters, hot days are significantly correlated with urolithiasis. In groundwater quality, EC, Na and F are convincingly correlated with urolith patients, which concludes the strong relation between geo-environment and urolithiasis.

Impact of fluid intake in the prevention of urinary system diseases: a brief review

We are often told that we should be drinking more water, but the rationale for this remains unclear and no recommendations currently exist for a healthy fluid intake supported by rigorous scientific evidence. Crucially, the same lack of evidence precludes the claim that a high fluid intake has no clinical benefit. The aim of this study is to describe the mechanisms by which chronic low fluid intake may play a crucial role in the pathologies of four key diseases of the urinary system: urolithiasis, urinary tract infection, chronic kidney disease and bladder cancer. Although primary and secondary intervention studies evaluating the impact of fluid intake are lacking, published data from observational studies appears to suggest that chronic low fluid intake may be an important factor in the pathogenesis of these diseases.