The stone crescent of Anatolia

Abstract

Objectives To assess the largest stone composition data available and to present the variations in the stone composition according to gender and different climatic environments in Turkey. Methodology Data for a total of 24 768 urinary stone patients from the Turkish Mineral Research and Exploration Institute were evaluated. X‐ray diffraction crystallography was used for analysis and the Köppen‐Trewartha classification was used to assess the climatic features of the cities. After the assessment, the cities were divided into two groups—those with a continental climate (Dc) were defined as inland areas and the others (Non‐Dc) were defined as coastal areas. Results The male‐to‐female ratio was 2.2:1. Amongst the patients, 53.7% had pure stones, while 46.3% had mixed‐type stones. The most common type of stone was calcium oxalate in both pure and mixed stone groups. Given the climate patterns, the stone ratio between regions with a Dc climate and a Non‐Dc climate was approximately 2:3. Cystine and uric acid stones were observed more frequently in inland regions, while calcium oxalate, whewellite, and struvite stones were observed more frequently in coastal areas (P = .005, P < .001, P < .001, P = .002, P = .002, respectively). Calcium oxalate stones were found at a higher rate in men, while cysteine, struvite, and calcium phosphate stones were more common in women (P < .001, P = .003, P < .001, P < .001, respectively). Conclusion This study provides the most comprehensive data on the stone disease in Turkey. Considering the distribution of stone disease in Turkey, the frequency of analysed stones had parallels with the temperature averages and climate features, presenting crescent‐like distribution.

Prevalence and trends of urolithiasis among adults

“…Inversely, no significant rise in uric acid stones was observed in a study conducted in Italy [24]. Also, in Turkey, calcium oxalate (CaOx) stones have markedly increased from 2006 to 2019 [19]. In addition, there were more uric acid and cystine stones in the Turkish inland areas, which might be because of higher animal protein consumption and more consanguinity marriage in the inland than in other regions across Turkey, as stated by the authors [19].…”

“…Altai was a leading region in obesity, hypertension, and diabetes prevalence, which can explain the higher frequency of urolithiasis [13 ▪ ]. In Turkey, they found that urolithiasis had a crescent-shape distribution with more stones detected in coastal than inland areas; which can be explained by climate variations as inland had a higher average temperature than other regions [19]. Chen and Chen [15] reported a higher prevalence of urolithiasis in New Brunswick compared with studies conducted in other Canadian provinces.…”

“…In the United States, the male-to-female ratio has declined from 1.46 in 2005 to 1.08 in 2014 [27 ▪ ]. Conversely, a study conducted in Turkey reported a significant increase in the male-to-female ratio from 2.1 : 1 during 2006–2012 to 2.3 : 1 during 2013–2019 [19]. Moreover, the male-to-female ratio varied between different age groups.…”

“…Also, in Turkey, calcium oxalate (CaOx) stones have markedly increased from 2006 to 2019 [19]. In addition, there were more uric acid and cystine stones in the Turkish inland areas, which might be because of higher animal protein consumption and more consanguinity marriage in the inland than in other regions across Turkey, as stated by the authors [19]. Analysis of 23 182 kidney stones in China revealed an increasing trend in uric acid and struvite stones, whereas CaOx decreased significantly from 2011 to 2019 [14 ▪ ].…”

“…Table 1 summarizes the findings of the studies that met our inclusion criteria. Twenty-three studies were identified reporting on urolithiasis epidemiology, prevalence, and trends from 11 different countries in the past 2 years [6 ▪▪ ,12,13 ▪ ,14 ▪ ,15,16 ▪▪ ,17,18 ▪ ,19–26,27 ▪ ,28–33].…”