The influence of environmental conditions on the incidence of renal colic in Rome

The role of the general practictioner in the management of urinary calculi

BACKGROUND

The prevalence of kidney stones tends to increase worldwide due to dietary and climate changes. Disease management involves a high consumption of healthcare system resources which can be reduced with primary prevention measures and prophylaxis of recurrences. In this field, collaboration between general practitioners (GPs) and hospitals is crucial.

METHODS

a panel composed of general practitioners and academic and hospital clinicians expert in the treatment of urinary stones met with the aim of identifying the activities that require the participation of the GP in the management process of the kidney stone patient.

RESULTS

Collaboration between GP and hospital was found crucial in the treatment of renal colic and its infectious complications, expulsive treatment of ureteral stones, chemolysis of uric acid stones, long-term follow-up after active treatment of urinary stones, prevention of recurrence and primary prevention in the general population.

CONCLUSIONS

The role of the GP is crucial in the management and prevention of urinary stones. Community hospitals which are normally led by GPs in liaison with consultants and other health professional can have a role in assisting multidisciplinary working as extended primary care.

The influence of climatic factors in the seasonal fluctuation of urolithiasis and the trend of stone disease management in the southern Taiwan

This study aims to analyze the effects of climate parameters on the number of urolithiasis treatments in our hospital and understand the effects of climate parameters on the prevalence of urolithiasis in southern Taiwan. We also look at trends associated with urolithiasis and treatments. Retrospectively reviewed the records of extracorporeal shockwave lithotripsy (ESWL), ureteroscopy (URS), retrograde intrarenal surgery (RIRS), and percutaneous nephrolithotripsy (PCNL) performed in our hospital from January 2012 to December 2018. Climate data for were collected from Central Weather Bureau. The monthly meteorological data included average temperatures, humidity, rainfall, sunshine hours, atmospheric pressure, and wind speed. Monthly numbers of patients undergoing stone management was positively correlated to average temperature (r = 0.657), relative humidity (r = 0.234), monthly rainfall (r = 0.261) and monthly sunshine hours (r = 0.348), while it was negatively correlated to atmospheric pressure (r = - 0.522). The multivariate linear regression model demonstrated temperature (ß = 10.682, 95% CI 6.178-14.646, p < 0.001) and Relative humidity (ß = - 95% CI - 5.233- - 1.216, p = 0.002) to be independently related to numbers of stone treatment. The data also revealed a rising prevalence of urolithiasis with an associated increase in the number of interventions, with fewer ESWL (74.0-49.4%). Temperature and relative humidity are associated with monthly numbers of stone treatment. Ambient temperature is the most critical climate factor affecting the prevalence of symptomatic urolithiasis and intention of active stone removal in southern Taiwan.

Study on the prevalence and incidence of urolithiasis in Korea over the last 10 years: An analysis of National Health Insurance Data

Purpose

We aimed to analyze the incidence and prevalence of urolithiasis in Korea over the last decade using the National Health Insurance (NHI) sample cohort data.

Materials and Methods

From January 2002 to December 2013, we enrolled sample cohort data from the NHI. Patients diagnosed with international classification of diseases code N20 or N13.2 were included. The incidence and prevalence rate was counted from the same period and patients previously diagnosed with urolithiasis were excluded. We compared the incidence and prevalence of urolithiasis by region, age, and sex, and identified the changes.

Results

Total 1,111,828 subjects were included. Of these subjects, 36,857 had urolithiasis. The male-to-female ratio was 1.57:1, and total incidence rate was 3.27 per 1,000 person-years (1,000p-yrs). The annual incidence was lowest in 2013 (3,138 patients) and highest in 2005 (3,751 patients). Incidence rate by diagnostic code was highest in ureter stone only (2.49 per 1,000p-yrs) and was lowest in kidney and ureter stone both (0.17 per 1,000p-yrs). Prevalence gradually increased from 3,172 in 2002 and 5,758 in 2013. Jeollanam-do had the highest incidence rate of 3.70 persons per 1,000p-yrs, and Jeju had the lowest rate of 2.84 persons per 1,000p-yrs. In gender analysis, Daegu had the highest incidence (4.56) in males, Jeollanam-do had the highest incidence (3.20) in females.

Conclusions

Annual incidence remained stable, whereas prevalence gradually increased. The incidence in male was 1.57 times higher than female, and the peak incidence age was 45–49 years, with the highest incidence occurring in Jeollanam-do and the lowest in Jeju.