Research Journal of Medical Sciences
ISSN: Online 1993-6095ISSN: Print 1815-9346
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Evaluation of the Role of Metabolic Risk Factors Among Patients Presenting with Recurrent Urolithiasis in A Tertiay Care Hospital
G. Mamatha, B.C. Satheesha, D.N. Jyothi, B.H. Rakesh, Shreelaxmi V. Hegde and H.C. Shivakumar
Page: 407-415 | Received 19 May 2024, Published online: 26 Jul 2024
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Abstract
The most frequent urological disease is urolithiasis, which varies significantly in frequency across different geographic regions and is observed to be common in ethnic groups. The lifetime risk of urolithiasis varies from 1%‐5% in Asia, 5%‐9% in Europe, 10%‐15% in the USA, and 20%‐25% in the Middle East, with Greenland and Japan reporting the lowest prevalence. The incidence of urinary tract stone illness is on the rise. The prevalence of the disease is lower in Asian nations and higher in the population of the West, particularly America. North India has a higher prevalence of the disease than South India. The objectives of the study was to evaluate the metabolic risk factors in patients with recurrent urolithiasis and to study the relation between epidemiological factors and 24 hour urinary metabolic abnormalities During the course of a year, a prospective observational study involving 100 patients with recurrent urolithiasis was carried out. Following pertinent history‐taking, a thorough examination of each patient was performed. As needed, serum electrolytes, calcium, uric acid, phosphorus and PTH were evaluated. An analysis was conducted on the estimated 24‐hour urine excretion of calcium, salt, creatinine, phosphorus, uric acid, magnesium, potassium, oxalate and citrate. A p<0.05 was deemed significant for the statistical analysis that was conducted using the Pearson's correlation test, the Fischer exact test and the Chi square test. The mean age of urolithiasis was 43.7±13.045 with a male to female ratio of 3.5:1. The main presenting complaint was loin pain and 45% patients were found to have calcium oxalate stones on chemical analysis. An underlying metabolic abnormality was noted in 95% patients with 5% having no abnormality. Almost 66 patients (66%) had two or more abnormalities. The metabolic abnormalities detected were: hypocitraturia (63%) hyperoxaluria (54%), hypercalciuria (28%), hypernatriuria (26%), hyperuricosuria (14%) and low urine volume (13%). Hypercalcemia was noted in 2 patients (2%) and both had raised PTH. The presence of hypocitraturia in vegetarian type of diet, and hypercalciuria in female gender correlated in a statistically significant manner (p<0.05). There was a significant positive correlation between the urinary excretion of sodium and calcium, as well as excretion of sodium and oxalate in urine. Recurrent urolithiasis is predominantly seen in the males and the frequency of metabolic abnormalities is very high. Hypocitraturia, hyperoxaluria, hypercalciuria and hypernatriuria are the most important metabolic abnormalities. Hypocitraturia is associated with vegetarian diet and hypercalciuria was significant in women when compared to men. Hypernatriuria has a calciuric effect. The spectrum of metabolic abnormalities is different in our population as compared to the western population.
How to cite this article:
G. Mamatha, B.C. Satheesha, D.N. Jyothi, B.H. Rakesh, Shreelaxmi V. Hegde and H.C. Shivakumar. Evaluation of the Role of Metabolic Risk Factors Among Patients Presenting with Recurrent Urolithiasis in A Tertiay Care Hospital.
DOI: https://doi.org/10.36478/10.36478/makrjms.2024.8.407.415
URL: https://www.makhillpublications.co/view-article/1815-9346/10.36478/makrjms.2024.8.407.415