| Background Urolithiasis is a common disease occurring in both developed and developing countries,and its prevalence has been gradually increasing over several decades.Several studies have shown that the risk of developing urolithiasis is apparently higher in Western countries(5%-9% in Europe and 13%-15% in the United States)than in Asian countries(1%-5%).In a given population,the stone compositions were influenced by many variables,including age,gender,genetic,climatic,dietary and social factors.Children with nephrolithiasis often have a high recurrence rate and risk of long-term detrimental effects on kidney function.Although urinary stone disease remains less frequent in children than in adults,the prevalence of urolithiasis in the pediatric population is increasing worldwide over the past few decades.It was reported that a high incidence of nephrolithiasis of children,ranging from 33 to 93 %,was associated with metabolic abnormalities due to the effects of environmental or dietary factors.Local conditions in Xinjiang,such as weather,geographic location,and nutritional condition may play a major role in defining the profile of urolithiasis.Therefore,analysis of stone composition would be beneficial to reveal the underlying metabolic risk factors and to explore a proper strategy for stone treatment and prevention.So far,there is a paucity of study on epidemiological characteristics of urinary calculi in Kashgar,an Uygur nationality area in Northwestern China.Hence,in the present study,we retrospectively analyzed the stone compositions of 732 consecutive patients underwent surgical treatment in Kashgar during 2015 to 2016,and correlated them to the gender,age.Objective To analyze urinary stone compositions in patients from Kashgar,Xinjiang.Materials and Methods We analyzed the components of urinary stones in 732 consecutive patients with urolithiasis admitted to the First and Second People's Hospital of Kashgar Prefecture,Xinjiang,from July 2015 to November 2016.The patients were divided into two groups by ages: group A,0–18 years old and group B,>18 years old.To further discuss the relationship between stone composition and age distribution,patients were subdivided into 8 subgroups: <1 years old,1-3 years old,4-6 years old,10-18 years old,19-40 years old,41-60 years old and >60 years old.Results1.Of the 732 cases of stone patients,428 cases were male,304 cases were female,aged between 3 months and 76 years old;The ratio of 0-18 years old group was 58.47%,with an average age of 3.90±4.09 years old,while >18 years old group accounting for 41.53%,with an average age of 39.88±16.40 years,the overall male-to-female ratio was 2.27:1.Pure stones accounted for 63.80% and mixed stones accounted for 36.20%.2.The main components of stones were ammonium acid urate(AAU)stones,accounting for 35.63% and 33.48% of male and female patients respectively,followed by calcium oxalate stones(30.91% male and 31.25% female for calcium oxalate monohydrate;1.78% male and 2.68% female for calcium oxalate dihydrate),uric acid stones(17.72% for male,13.84% for female),calcium phosphate stones(5.12% for male,4.91% for female),magnesium ammonium phosphate(4.53% for male,6.25% for female),and carbonic acid phosphorous gray Stones(male 1.38%,female 4.91%)and other stones(male 2.95%,female 2.68%).Female patients in carbonate apatite were significantly more than men(P=0.004),and there was no statistical difference in the distribution of gender among the remaining stones(P>0.01).Calcium oxalate stone is the main stone component in the upper urinary tract,and ammonium acid urate stone is the main stone component in the lower urinary tract.3.The two peak age groups of urolithiasis were 1-3 years old and 19-40 years old.There were differences in gender distribution among different age groups.In group of 1-3yrs patients,male were more than female(37.60% vs.24.55%,P=0.001),while in group of 10-18 yrs patients,female were more than male(10.71% vs.4.13%).AAU was the predominant stone component in group <1yrs(70.5%),1-3yrs(66.7%)and 4-6yrs(46.77%).AAU stone was more prevalent in group <1yrs(P<0.01,as compared with other groups).COM was the major stone component in group 7-9 yrs(45.16%),10-18 yrs(60.00%),19-40 yrs(52.43%)and 41-60 yrs(41.18%).Uric acid(UA)stone focus on group >60yrs(66.8%,P<0.01)than in other groups.There was no significant difference in the age distribution of other stones(P>0.01).4.Among the patients with AAU stone,the majority of cases were in upper urinary tract stones,mainly in the 1-3 year old group.Compared with upper urinary tract stones,there were significantly more male patients than female patients in lower urinary tract stones(P=0.001).Conclusion Most of the patients with urolithiasis diagnosed and treated in Kashgar are under 18 years old,especially younger than 3 years old.Male patients were more than female patients.The most frequent stone component in this area was AAU.More than 50% patients less than 18 years old had AAU stone.The mechanisms that could trigger the high prevalence of AAU stone in patients less than 18 years old are worth to be further investigated. |
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