Female stone disease: the changing trend

Abstract

This paper has attempted to assess the changes noted in the trends in the incidence and biochemical pattern of female urolithiasis patients during the period 1971-2008. A prospective descriptive clinical study was done on 8,590 stone patients belonging to both sexes treated at the urinary stone clinic. The incidence of stone disease among the two sexes was plotted. The various metabolic parameters including 24-h urine volume, urine calcium, phosphorus, uric acid, oxalate, magnesium, creatinine and citrate, serum creatinine, calcium, phosphorus, uric acid and magnesium and calculated parameter calcium:magnesium ratio were studied. The possible causes for the change in incidence of stone disease in the female sex were elucidated. Of the patients studied, 12.7% (1,091) were females. There was a definite increase in the incidence of female urolithiasis over the past 37 years (P < 0.001). There were significant variations in urine biochemical parameters. There was a definite increase in the excretion of urinary calcium over the years (P < 0.001). The excretion rate of oxalate in urine of females also increased steadily over the years (P < 0.001). The magnesium in urine of females reduced over the years (P < 0.001). Urinary citric acid has however shown an increase over the years (P < 0.001). Urinary excretion of phosphorus (P < 0.001) and urinary uric acid (P < 0.001) showed a decreasing trend. There was a considerable increase in the percentage of females with high calcium:magnesium ratio over the years (P < 0.001). There was a definite decrease in female patients with hypercalcemia over the years. Serum phosphorus and magnesium also increased significantly with the passage of time. Serum uric acid did not vary significantly through the years. The decrease in the excretion rate of magnesium which is inhibitory to stone genesis, together with the increased excretion of calcium and oxalate may have contributed to the increasing incidence of stone disease in females. This might be due to changes in living standards and dietary habits.

Biochemical diagnosis in 3040 kidney stone formers in Argentina

“…Fazil Marickar et al [25] studied between 1971 and 2008, 8590 kidney stone formers, men and women, finding an increasing proportion of female stone formers in the last 37 years, due to a significant increase in urine calcium excretion, changing the normal range from 147 mg/24 h in the 70 s to 230 mg/24 h between 2003 and 2008 with a mean of 195 mg/24 h. Besides, they also find an increase in oxalate urine excretion and a decrease in urine magnesium excretion. In our present series compared to the previous one, we could not demonstrate this tendency of higher urine calcium excretion in women and men [10], but we did observe a higher number of women suffering idiopathic hypercalciuria and low urine magnesium excretion.…”

Micropercutaneous nephrolithotomy (microperc) vs retrograde intrarenal surgery for the management of small renal calculi: a randomized controlled trial

“…The incidence of renal calculi is rising and more patients are presenting with small renal calculi. The treatment options for small renal calculi (<1.5 cm) are ESWL, percutaneous nephrolithotomy (PCNL) and retrograde intrarenal surgery (RIRS) .…”

Clinical factors associated with susceptibility to infection stone formation: A Retrospective Single-Center Analysis

“…With improvements in medical quality, the current incidence of infection stones has significantly decreased. Marickar and Vijay have demonstrated that although the incidence of stone diseases has significantly increased in recent years, the incidence of infection stones in female patients has significantly decreased [10]. Similarly, the reduction in the incidence of staghorn calculi in Europe supports the notion that infection stones constitute the majority of large stones [2].…”