Prevalence and characterization of urolithiasis in the Western region of Saudi Arabia

Prevalence of urolithiasis in Saudi Arabia: A systematic literature review

Urolithiasis is a common urological disease that can have a negative impact on health and quality of life in people worldwide. Multiple studies have investigated the prevalence of urolithiasis worldwide. However, research on this disease in Saudi Arabia is very limited. This review was conducted to investigate the prevalence of urolithiasis and its associations in Saudi Arabia. A standardized, systematic search strategy was conducted to identify observational studies that reported the prevalence of urolithiasis in Saudi Arabia. The search included published studies between January 2000 and October 2023. A variation in prevalence between regions was found and was reported to range from 6% to 19%. A significant association between urolithiasis and two factors, increasing age and family history, was found. Studies on urolithiasis are limited in Saudi Arabia. Despite this, it is evident that the prevalence of urolithiasis is comparable in other parts of the world. Public awareness and lifestyle modification efforts may help reduce this disease's impact on our population.

Utilization of barley and parsley for the management of urolithiasis among the Saudi Arabian population

Objective

To determine the utilization of barley and parsley for managing urolithiasis among the Saudi Arabian population.

Methods

This is a prospective cross-sectional survey-based study. The survey comprised questions about the use of barley, parsley, and other therapies for managing urolithiasis. A WhatsApp® message with the link to the study survey was sent out to family, friends, patients, and other acquaintances residing in the Kingdom of Saudi Arabia (KSA).

Results

A total of 1014 respondents completed the survey, of which 44.8% indicated that they utilized barley, 38.3% stated that they used parsley, and 4.2% indicated that they utilized other non-medical remedies to treat or prevent kidney stones. In contrast, only 29.5% stated that they utilized potassium citrate and/or magnesium citrate, and only 14.4% indicated that they consumed greater amounts of water to treat or prevent kidney stones.

Conclusion

Our study findings indicate that among the Saudi Arabian population, non-conventional therapies such as barley and parsley are more commonly utilized for managing urolithiasis rather than established therapies such as increasing water intake and the use of potassium-citrate/ magnesium-citrate. There is a need to conduct large-scale clinical studies to evaluate the efficacy and safety of barley, parsley, and other non-conventional therapies for treating urolithiasis.

The Saudi urological association guidelines on urolithiasis

Aims

The Saudi Urolithiasis Guidelines are a set of recommendations for diagnosing, evaluating, and treating urolithiasis in the Saudi population. These guidelines are based on the latest evidence and expert consensus to improve patient outcomes and optimize care delivery. They cover the various aspects of urolithiasis, including risk factors, diagnosis, medical and surgical treatments, and prevention strategies. By following these guidelines, health-care professionals can improve care quality for individuals with urolithiasis in Saudi Arabia.

Panel

The Saudi Urolithiasis Guidelines Panel consists of urologists specialized in endourology with expertise in urolithiasis and consultation with a guideline methodologist. All panelists involved in this document have submitted statements disclosing any potential conflicts of interest.

Methods

The Saudi Guidelines on Urolithiasis were developed by relying primarily on established international guidelines to adopt or adapt the most appropriate guidance for the Saudi context. When necessary, the panel modified the phrasing of recommendations from different sources to ensure consistency within the document. To address areas less well covered in existing guidelines, the panel conducted a directed literature search for high quality evidence published in English, including meta analyses, randomized controlled trials, and prospective nonrandomized comparative studies. The panel also searched for locally relevant studies containing information unique to the Saudi Arabian population. The recommendations are formulated with a direction and strength of recommendation based on GRADE terminology and interpretation while relying on existing summaries of evidence from the existing guidelines.

Prevalence and Risk Factors of Renal Stones Among the Bisha Population, Saudi Arabia

BACKGROUND

In urolithiasis, urinary calculi are formed in the urinary system. Stone development does not initially result in any symptoms, but later renal colic, flank pain, hematuria, obstruction of urine flow, and/or hydronephrosis may indicate renal stone disease. In addition to age, gender, ethnicity, and local climate, urolithiasis can be caused by several other factors. The prevalence and recurrence rate of kidney stone disease is rising globally, while few effective treatment options currently exist.

METHODS

Between June and October 2022, a cross-sectional study was conducted. An electronic questionnaire subdivided into three categories was used to determine the prevalence and identify the factors that increase the likelihood of developing urolithiasis among the population in Bisha. The collected data were reviewed and analyzed via IBM Corp. Released 2012. IBM SPSS Statistics for Windows, Version 21.0. Armonk, NY: IBM Corp.

RESULTS

A total of 1,002 participants filled out the questionnaire. The age of the participants ranged from 18 to over 60 years, with an average age of 26.1 ± 13.9 years. There were 451 female participants (45%), and 927 (92.5%) were Saudis. According to the participants' body mass index, 98 (9.8%) were underweight, 388 (38.7%) were normal weight, 300 (29.9%) were overweight, and 216 (21.6%) were obese. The total number of participants with urolithiasis was 161 (16.1%), and 420 (41.9%) had a family history of renal stones. Urolithiasis was found to be significantly associated with family history, smoking, diabetes, hypertension, hyperthyroidism, gout, and chronic kidney disease. Older age and female gender were also associated with the risk of having urolithiasis.

CONCLUSION

This study found urolithiasis to be highly prevalent among the Bisha population. In terms of risk factors, body mass index, smoking, and diabetes were the most significant. Based on the findings of this study, the authors recommend more public education regarding urolithiasis and its risk factors, emphasizing the importance of preventing the disease and the ways of treating urolithiasis through medical campaigns and social media.

Trends of Acute Renal Colic During COVID-19 Lockdown: An Experience From Saudi Arabia

Introduction

The COVID-19 pandemic represents an unprecedented challenge for healthcare systems around the world. Saudi Arabia was one of the first countries to experience a lockdown and postponement of elective surgical procedures. The objective of this study was to assess the trends of acute renal colic presenting to our emergency department.

Methods

This retrospective study targeted all patients who presented with acute renal colic during the lockdown period (March 23, 2019 to June 20, 2019). Patients’ and stone data were collected. The patient’s data included age, gender, BMI, and comorbidities. Stones' data included stone size, location, side, evidence of obstruction and UTI, and planned and conducted management.

Results

A total of 137 patients were identified; 92 (67.2%) patients were males with a mean age of 44 ± 16 years. Positive history of urolithiasis was reported in 47 (34.3%). The most common initial investigation was non-contrast CTs (93.4%). The majority of patients had a stone size of < 10 mm (93%) and ureteric stones (81.2%). A total of 32 patients (32.4%) had evidence of UTI and 63.4% had evidence of obstruction. Most of the patients (73.7%) were offered medical expulsive therapy (MET). Only 2.2% did not receive the planned management.

Conclusion

The observed pattern shows that the management during the lockdown did not differ from the original recommendations. This could be due to the fact that most patients had stone sizes between 5 and 10 mm and consequently were managed by METs. Larger data need to be conducted to provide concrete evidence. Such data are relevant to provide a clear guide for management and to establish protocols for emergency lockdown situations.

R. S, Toh CC, Sundram M, Md Yusoff NA, Nagappan P, Kamaruzaman S, Yeoh WS, Ong TA, Lim J. Cardiovascular risk factors, ethnicity and infection stone are independent factors associated with reduced renal function in renal stone formers

BACKGROUND

Recent evidence suggested the link between nephrolithiasis and renal function impairment. We aimed to determine the renal function profile and potential factors associated with reduced renal function amongst renal stone formers in multi-ethnic Asians.

METHODS

We conducted a cross-sectional study involving patients undergoing percutaneous nephrolithotomy between May 2015 and December 2019. Reduced renal function was defined as having estimated glomerular filtration rate < 60 ml/min per 1.73 m2. Renal stone samples were collected and quantified using infrared spectroscopy. Potential factors associated with reduced renal function including age, ethnicity, educational level, history of diabetes, hypertension, gout, hydronephrosis, serum uric acid level, and type of renal stone were evaluated using univariable and multivariable analyses.

RESULTS

A total of 1162 patients from a multi-ethnic population (Malays 67%, Chinese 19%, Indians 13% and indigenous people 1%) with median age of 57 years (Interquartile range 48-64) were enrolled in the study. Almost a third of patients were found with reduced renal function. Multivariable analysis showed that the odds of having reduced renal function increased with age, ethnicity, lower educational level, history of diabetes, hypertension, gout, bilateral hydronephrosis, elevated serum uric acid level and infection stone.

CONCLUSIONS

Reduced renal function varies between ethnicities and all age groups of renal stone formers. In addition to age and ethnicity, cardiovascular risk factors including diabetes and hypertension may also need to be taken into account in managing stone patients with reduced renal function.

Perceptions of dietary factors promoting and preventing kidney stones among Taif City Population - A cross-sectional study

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Methods:

Results:

Conclusion:

Effect of Phaseolus Vulgaris on Urinary Biochemical Parameters among Patients with Kidney Stones in Saudi Arabia

The study purpose was to investigate the effect of Phaseolus Vulgaris (PV) on urinary biochemical parameters among patients with kidney stones. We conducted a randomized controlled study among 60 patients with kidney stones (size < 10 mm) in the nephrology unit of both government and private hospitals, Al-Ahsa. Urinary volume, calcium, magnesium, potassium, oxalate, uric acid, and power of hydrogen (pH) were assessed before and after the intervention of giving 250 g of PV consumption as an extract thrice weekly (2.2 L to 2.5 L per week) for 6 weeks, which was compared with control. A 't' test was used with the significance at 5%. Mean score of age was 44.5 ± 10.16 in PV group and 43.73 ± 9.79 in control. Four (13.3%) and two (6.7%) had family history of kidney stones. Body mass Index (BMI) mean was 26.44 ± 2.7 and 26.36 ± 2.65 in pre and post-test, respectively, which were significant (p = 0.01017). There were significant changes (p = 0.000) in urine volume from 1962 ± 152.8 to 2005 ± 148.8, calcium 205.4 ± 11.99 to 198.4 ± 12.52, potassium 44.07 ± 3.66 to 52.15 ± 4.37, oxalate 37.12 ± 5.38 to 33.02 ± 5.71, and uric acid 6.88 ± 0.7 to 6.31 ± 0.58. In conclusion, PV is effective management for the patients with kidney stones as it increases the urinary volume and enhances the elimination of small kidney stones.

The Prevalence of Incidentally Detected Urolithiasis in Subjects Undergoing Computerized Tomography

Background and objective

Urolithiasis is defined as the presence of calculi in the urinary tract. Multiple studies have shown that urinary tract stones are one of the most common incidental findings in medical imaging. These stones are potentially dangerous and can cause severe impairment to renal function if they remain undiagnosed for a long time. The objective of this study was to determine the prevalence of incidentally detected urolithiasis in patients undergoing abdominopelvic CT scans.

Materials and methods

A retrospective cross-sectional study was conducted, which involved 721 patients selected by consecutive non-randomized sampling. The study population included patients who underwent an abdominopelvic CT scan in the radiology department of a tertiary care hospital in Pakistan. Patients aged below 10 years and those above 90 years were excluded from the study. Patients undergoing kidney, ureter, and bladder (KUB) scan for urolithiasis-associated symptoms and those with already known urolithiasis were also excluded. The data were recorded in a predesigned pro forma and analyzed with SPSS Statistics version 20.00 (IBM, Armonk, NY).

Results

A total of 721 patients underwent an abdominopelvic CT scan during the six months from July to December in the radiology department of the hospital. Out of these, 336 (46.6%) were males, and 385 (53.4%) were females. Incidental stones were found in 20 of these patients. Among these 20 stone formers, 11 were males, and nine were females. Out of them, six had stones in the right kidney, eight in the left kidney, and four patients had bilateral stones. The remaining two patients had stones in their ureters. In most cases, stones were found in lower poles as compared to the mid pole and upper pole of the kidneys.

Conclusion

The prevalence of incidentally detected urolithiasis was found to be 2.8% in this study. Its frequency was much higher in males (3.27%) compared to females (2.33%). Most of the stones were found in the kidneys whereas no stone was detected in the urinary bladder.

Gender and side distribution of urinary calculi using ultrasound imaging

Introduction:

Urinary calculi constitute a significant medical problem worldwide. Due to lack of previous studies on gender and side distribution of urinary calculi, the current study was conducted.

Patients and Methods:

This retrospective study involved 590 urinary calculi from the electronic reports of 266 patients. Gender and side distribution were compared using Chi-square test. Relationship between gender and side of urinary calculi was analyzed using cross tabulation test.

Results:

This study involved 590 urinary calculi reported in 266 patients. Among 590 calculi; 565 (95.8%) were in adults, and 25 (4.2%) were in children. Urinary calculi were in male in 397 (67.3%) and in female in 193 (32.7%). Calculi were 304 (51.5%) in right side, and 286 (48.5%) in left side. Exactly 507 (85.9%) of calculi were in the kidneys, and 83 (14.1%) in the ureters. No significant relationship between gender and side of the calculi (P = 0.238), (Odds ratio 0.869, 95% Confidence interval 0.615-1.226).

Conclusion:

Urinary calculi affect male more than female and adults more than children. No significant relationship between calculi and right or left side of the body.