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Trends in urinary stone composition in 23,182 stone analyses from 2011 to 2019: a high-volume center study in China

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World Journal of Urology Aims and scope Submit manuscript

A Letter to the Editor to this article was published on 15 April 2021

Abstract

Purpose

To evaluate the distribution and dynamic trends in constituents of urinary stones in China.

Materials and methods

The composition of 23,182 stones were analyzed and then recorded between January 2011 and December 2019. The characteristics in terms of stone patient’s gender, age and calendar year were analyzed.

Results

Most stones (22,172, 95.64%) had several crystal components, among which 40.25% (8925/22,172) were mixtures with infection components. Calcium oxalate (CaOx) and uric acid (UA) stones were more commonly encountered in men, but calcium phosphate (CaP), magnesium ammonium phosphate (MAP) and carbonate apatite (CA) stones were more prevalent in women (p < 0.05). In males, the proportion of CaOx stones increased up to the age of 40, but subsequently decreased (p < 0.001). Interestingly, females showed an inverse trend regarding CaOx stones (p < 0.001). The proportion of UA stones increased with age (p < 0.001), and CA stones most frequently were recorded at age 20–49. Over the past 9 years, UA, CA, and MAP stones increased over time, whereas there was a tendency for CaOx stones to decrease (p < 0.05).

Conclusions

The scarcity of pure stones and a certain proportion of mixtures with infection stone components (e.g., mixtures of CaOx and CA) suggest that treatment directed against a single stone component is insufficient for effective recurrence prevention. Age and gender were significant determinants of stone composition, and according to the observed chronological trends, it seems that in the future, more UA, CA and MAP stones and fewer CaOx stones may be encountered in the studied population.

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References

  1. Friedlander JI, Antonelli JA, Pearle MS (2015) Diet: from food to stone. World J Urol 33(2):179–185

    Article  CAS  Google Scholar 

  2. Fram EB, Sorensen MD, Bird VG et al (2017) Geographic location is an important determinant of risk factors for stone disease. Urolithiasis 45(5):429–433

    Article  Google Scholar 

  3. Eisner BH, Goldfarb DS (2014) A nomogram for the prediction of kidney stone recurrence. J Am Soc Nephrol 25(12):2685–2687

    Article  Google Scholar 

  4. Moe OW (2006) Kidney stones: pathophysiology and medical management. Lancet 367(9507):333–344

    Article  CAS  Google Scholar 

  5. Turk C, Skolarikos A, Neisius A, et al. EAU guidelines on urolithiasis. In: EAoUG Office, editor. EAU guidelines. Edn published as the 35th EAU Annual Meeting, Amsterdam. Arnhem, the Netherlands: European Association of Urology Guidelines Office; 2020

  6. Sorokin I, Mamoulakis C, Miyazawa K et al (2017) Epidemiology of stone disease across the world. World J Urol 35(9):1301–1320

    Article  Google Scholar 

  7. Zeng G, Mai Z, Xia S et al (2017) Prevalence of kidney stones in China: an ultrasonography based cross-sectional study. BJU Int 120(1):109–116

    Article  Google Scholar 

  8. Sakamoto S, Miyazawa K, Yasui T et al (2019) Chronological changes in epidemiological characteristics of lower urinary tract urolithiasis in Japan. Int J Urol 26(1):96–101

    Article  CAS  Google Scholar 

  9. Kang HW, Seo SP, Ha YS et al (2017) Chronological trends in clinical and urinary metabolic features over 20 years in Korean urolithiasis patients. J Korean Med Sci 32(9):1496–1501

    Article  CAS  Google Scholar 

  10. Knoll T, Schubert AB, Fahlenkamp D et al (2011) Urolithiasis through the ages: data on more than 200,000 urinary stone analyses. J Urol 185(4):1304–1311

    Article  Google Scholar 

  11. Zhai F, Wang H, Du S et al (2007) Lifespan nutrition and changing socio-economic conditions in China. Asia Pac J Clin Nutr 16(Suppl 1):374–382

    PubMed  Google Scholar 

  12. Castiglione V, Sacré PY, Cavalier E et al (2018) Raman chemical imaging, a new tool in kidney stone structure analysis: case-study and comparison to Fourier Transform Infrared spectroscopy. PLoS ONE 13(8):e0201460

    Article  Google Scholar 

  13. Kravdal G, Helgø D, Moe MK (2015) Infrared spectroscopy is the gold standard for kidney stone analysis. Tidsskr Nor Laegeforen 135(4):313–314

    Article  Google Scholar 

  14. Wu W, Yang B, Ou L, Liang Y et al (2014) Urinary stone analysis on 12,846 patients: a report from a single center in China. Urolithiasis 42(1):39–43

    Article  Google Scholar 

  15. Corrales M, Doizi S, Barghouthy Y et al (2020) Classification of stones according to Michel Daudon: a narrative review. Eur Urol Focus. https://doi.org/10.1016/j.euf.2020.11.004 (Epub ahead of print)

    Article  PubMed  Google Scholar 

  16. Jarrar K, Boedeker RH, Weidner W (1996) Struvite stones: long term follow up under metaphylaxis. Ann Urol (Paris) 30(3):112–117

    CAS  Google Scholar 

  17. Tiselius HG (2011) A hypothesis of calcium stone formation: an interpretation of stone research during the past decades. Urol Res 39(4):231–243

    Article  Google Scholar 

  18. Tiselius HG (2015) Should we modify the principles of risk evaluation and recurrence preventive treatment of patients with calcium oxalate stone disease in view of the etiologic importance of calcium phosphate? Urolithiasis 43(Suppl 1):47–57

    Article  Google Scholar 

  19. Lieske JC, Rule AD, Krambeck AE et al (2014) Stone composition as a function of age and sex. Clin J Am Soc Nephrol 9(12):2141–2146

    Article  Google Scholar 

  20. Daudon M, Doré JC, Jungers P et al (2004) Changes in stone composition according to age and gender of patients: a multivariate epidemiological approach. Urol Res 32(3):241–247

    Article  Google Scholar 

  21. Kurtz I, Dass PD, Cramer S (1990) The importance of renal ammonia metabolism to whole body acid-base balance: a reanalysis of the pathophysiology of renal tubular acidosis. Miner Electrolyte Metab 16(5):331–340

    CAS  PubMed  Google Scholar 

  22. Abate N, Chandalia M, Cabo-Chan AV Jr et al (2004) The metabolic syndrome and uric acid nephrolithiasis: novel features of renal manifestation of insulin resistance. Kidney Int 65(2):386–392

    Article  CAS  Google Scholar 

  23. Viaene L, Meijers BK, Vanrenterghem Y et al (2012) Evidence in favor of a severely impaired net intestinal calcium absorption in patients with (early-stage) chronic kidney disease. Am J Nephrol 35(5):434–441

    Article  CAS  Google Scholar 

  24. Malihi Z, Lawes CMM, Wu Z et al (2019) Monthly high-dose vitamin D supplementation does not increase kidney stone risk or serum calcium: results from a randomized controlled trial. Am J Clin Nutr 109(6):1578–1587

    Article  Google Scholar 

  25. Genazzani AD, Lanzoni C, Genazzani AR (2007) Might DHEA be considered a beneficial replacement therapy in the elderly? Drugs Aging 24(3):173–185

    Article  CAS  Google Scholar 

  26. Borghi L, Schianchi T, Meschi T et al (2002) Comparison of two diets for the prevention of recurrent stones in idiopathic hypercalciuria. N Engl J Med 346(2):77–84

    Article  CAS  Google Scholar 

  27. Yang X, Zhang C, Qi S et al (2016) Multivariate analyses of urinary calculi composition: a 13-year single-center study. J Clin Lab Anal 30(6):873–879

    Article  CAS  Google Scholar 

  28. Hesse A, Brändle E, Wilbert D et al (2003) Study on the prevalence and incidence of urolithiasis in Germany comparing the years 1979 vs. 2000. Eur Urol 44(6):709–713

    Article  CAS  Google Scholar 

  29. Lee MC, Bariol SV (2013) Changes in upper urinary tract stone composition in Australia over the past 30 years. BJU Int 112(Suppl 2):65–68

    Article  Google Scholar 

  30. Krambeck AE, Lingeman JE, McAteer JA et al (2010) Analysis of mixed stones is prone to error: a study with US laboratories using micro CT for verification of sample content. Urol Res 38(6):469–475

    Article  Google Scholar 

  31. Ciftçioglu N, Björklund M, Kuorikoski K et al (1999) Nanobacteria: an infectious cause for kidney stone formation. Kidney Int 56(5):1893–1898

    Article  Google Scholar 

  32. Wollin DA, Skolarikos A, Preminger GM (2017) Obesity and metabolic stone disease. Curr Opin Urol 27(5):422–427

    Article  Google Scholar 

Download references

Funding

Grants from the National Natural Science Foundation, China (No. 82070719); Natural Science Foundation of Guangdong Province (No. 2020A151501198); Key Project of Basic Research and Applied Basic Research of Department of Education of Guangdong Province, China (No. 2018KZDXM056). Science and Technology Program of GuangZhou, China (No. 202002030042).

Author information

Author notes

  1. Shike Zhang, Yapeng Huang and Weizhou Wu are equally contributed to this work and should be considered as co-first authors.

Authors and Affiliations

  1. Department of Urology and Guangdong Key Laboratory of Urology, The First Affiliated Hospital of Guangzhou Medical University, Kangda Road #1, Haizhu District, Guangzhou, 510230, Guangdong, China

    Shike Zhang, Yapeng Huang, Weizhou Wu, Zhican He, LiLi Ou, Guohua Zeng & Wenqi Wu

  2. Division of Urology, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden

    Hans-Göran Tiselius

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  1. Shike Zhang
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  4. Zhican He
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Contributions

WQW and GHZ: project development; ZCH and LLO: data collection; SKZ, YPH and WZW: data analysis and manuscript writing; H-GT and WQW: manuscript editing. All the authors approved and contributed to the final manuscript.

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Correspondence to Guohua Zeng or Wenqi Wu.

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Zhang, S., Huang, Y., Wu, W. et al. Trends in urinary stone composition in 23,182 stone analyses from 2011 to 2019: a high-volume center study in China. World J Urol 39, 3599–3605 (2021). https://doi.org/10.1007/s00345-021-03680-y

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