Epidemiology of Stone Disease in Northern India

Abstract

Urinary stone disease is highly prevalent in North India, a part of the stone belt in Asia. Two distinct "stone belts" have been identi fi ed in the northwestern region (NW); stone disease is less common in the southern and eastern regions. Calcium oxalate (CaOx) comprises a greater proportion of stones than seen in Western studies. While struvite stones were common in older series from NW, CaOx remains the predominant stone now, even in staghorns. First-degree relatives of stone formers are at higher risk of developing urolithiasis and have signi fi cantly higher urinary calcium excretion as compared to the spouses of the stone formers. Urinary tract infection was found to be one of the principal risk factors of urinary stones in North India. Metabolic acidosis is present in up to 45.2 % of stone formers as compared with 10.8 % in non-stone formers. Only dietary calcium correlated signi fi cantly with serum and urine calcium in stone formers. Stone patients from North India were shown to have a signi fi cantly higher intake of dairy products such as curd and cheese as compared to nonstone cases. Lower concentrations of urinary magnesium, copper, and manganese were noted in stone formers. Zinc excretion was signi fi cantly higher in stone formers. A signi fi cantly higher urinary urate excretion has been shown among stone formers from Delhi and Rajasthan.

Epidemiology of urolithiasis in Asia

“…In addition, the prevalence and incidence of urolithiasis have increased in most of the countries of Asia over the last several decades. Apart from climate, dietary habits and genetic factors, the increasing usage and improvements in sensitivity of high-tech imaging examination technology (computed tomography or ultrasonography) [2] , [3] , [4] , [5] can also account for it. Besides, aging of population, especially Japanese [6] , also contributes to the increase in prevalence, which is consistent with the phenomenon that the peak onset age of urolithiasis has been increasing [7] .…”

“…About 30–70 years ago, lower urinary tract (LUT) stones, especially vesical stones, accounted for 30%–94% of all stones, were dominated categories in many countries, like China, Japan, India, Malaysia, Thailand and Pakistan. However, it has changed gradually as the economy developed (only taking up for 3%–15%), with the UUT stones increasing and comprising the major part of urolithiasis (holding approximately 85%–93%) [4] , [14] , [18] , [24] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] .…”

Demographic Diversity of Food Intake and Prevalence of Kidney Stone Diseases in Indian Continent

“…Out of this 12%, 50% of the population are severely affected with renal damage and thus even lead to loss of kidneys [19]. Unlike the South India where a few reported percentages affected from Urolithiasis, in North Indian there is a steep 15% of the population inside the regime of KSD [20]. So in the prospect of kidney stone belt that affected by KSD in India, a proper corollary needed to be established [20].…”

“…Unlike the South India where a few reported percentages affected from Urolithiasis, in North Indian there is a steep 15% of the population inside the regime of KSD [20]. So in the prospect of kidney stone belt that affected by KSD in India, a proper corollary needed to be established [20]. This stone beltoccupies areas of Maharashtra, Gujarat, Rajasthan, Punjab, Haryana, Delhi, Madhya Pradesh, Bihar and West Bengal (Fig.1).…”

The role of selected environmental factors and the type of work performed on the development of urolithiasis – a review paper

“…Individual factors include non-modifiable factors such as genetic determinants (mutations in the SLC3A1, SLC7A9, SLC22A12 and SLC2A9 genes or other adjacent ones) [15][16][17], ethnic origin, age, gender and lifestyle factors, i.e., eating habits, body mass index (BMI), dehydration, overweight, obesity, diabetes, hypertension, etc. It should also be noted that the presence of urinary stones may be associated with the occurrence of other diseases [18]. According to recent reports, a correlation between cancer and urolithiasis has been confirmed [19].…”