Clinical Features And Related Risk Factors Of Urinary Stone In Uyghur Patients With Urolithiasis

Backround and objective:Urolithiasis is a common disease of urology, and its incidence is increasing worldwide. The epidemiology of urinary stone disease has hitherto not been rigorously defined in China. The distribution of urinary stone disease in our country exists obvious regional differences, the prevalence also have differences between the races.Incidence of urinary tract calculi is so high in Xinjiang region, although there is no strict sense of the epidemiological investigation. Urolithiasis is a kind of common, frequently-occurring disease in Xinjiang. The incidence of urinary calculi has obvious ethnic, regional and population distribution characteristics in local area. The study data shows, Uyghur people has a higher incidence of calculi in Xinjiang. In this study, we found that the incidence of urinary stones in all ages has a special distribution. In the related research reports, compared with other races living in Xinjiang, the incidence of urinary stones of Uyghur children is relatively higher than other races. It may be related with the special geographical environment of Xinjiang, the genetic background and special dietary habits and children’s feeding of the Uyghur people. A urinary stone earlier onset age, the recurrence rate is high, the serious influence children’s growth and the quality of survival; To the crowd has a great influence on health and social economy.We found that, Uyghur children have a high resident ratio in our hospital. So we have to perform a comparative study with urinary stone composition and clinic features of pediatric Uyghur patient and the healthy check-up Uyghur children. We have compare the adult patient’s clinic date with Uyghur and Han in order to gain insights the characteristics of the urinary stones composition and clinical characteristics of Uyghur patient, and an 1: 1 matched case-control study was performed with risk and protective factors of Uyghur adult’s urinary calculi as to provide theoretical basis for the diagnosis, treatment and prevention of urinary stones in this area. Materials and methods:1.We retrospectively evaluated 220 Uyghur children with urolithiasis admitted to the People’s Hospital of Xinjiang Uyghur Autonomous Region between March 2009 and June 2011. The control group comprised of 100 Uyghur children without urolithiasis, who visited the Child Care Clinic for regular health check-ups.2.We analyzed the components of urinary stones in 317 adult patients with urolithiasis(152 Uyghur and 165 Han) admitted to our hospital from March 2009 to June 2011. Logistic regression analysis was performed to analyze the association between stone components and clinical characteristics of the patients.3.An 1: 1 matched case-control study was performed using data from our hospital from March 2012 to Jan 2013. The case group included 100 inpatients who were diagnosed urinary calculi, during the survey while other 100 urolithiasis and endocrine disease excluded inpatients who shared the same sex, within five years gap to the case group inpatients were for the control group. Logistic regression analysis was performed to analyze the association data.Statistical analyses of the data were performed using SPSS 19.0 for Windows(SPSS, Chicago, IL, USA). Results:1.Stone analysis was performed in 220 Uyghur children. The mean age of all children was 7.48±4.73 years. The overall sex ratio of the participants [male(M): female(F) ] was 2.23: 1. M: F ratio in control group was 1.17: 1, and their mean age was 6.61±0.47 years. A positive family history for urolithiasis was noted in 28 children(12.7%). The majority of the stones identified in our study were located in the upper urinary tract(84.5%); Infrared spectroscopic analysis showed that 141(64.1%) patients had pure single-component stones, while 79(35.9%) had stones of mixed composition. The most commonly found pure stone was ammonium urate(58.9%), while the most common mixed stone was a calcium oxalate mixture(91.1%). Urine analyses revealed urinary tract infections(UTIs) in 42.3% of the patient group and in 4.0% the control group. The mean urinary p H was 5.77±0.67 and 6.42±0.67, respectively(P<0.001). p H values were<5.5 in 52.7% and 6.0% of the patient and control groups, respectively. In the patient group, metabolic disturbances were found on 24-h urine analysis: hypercalciuria occurred in 15 patients(6.8%), hyperphosphaturia in 37 patients(16.8%), hyperuricosuria in 47 patients(21.4%), and hypomagnesiuria in 75 patients(34.1%).2.There were significant differences in age; geographic distribution; serum concentrations of uric acid, potassium, and phosphorus; urine magnesium concentrations; and 24-hr volumes of urine between Uyghur and Han patients. There were also significant differences in stone components of calcium oxalate monohydrate(COM), calcium oxalate dihydrate(COD) +carbapatite(CA), and uric acid(UA) between Uyghur and Han patients. There were no significant differences in gender, family history, complications, sites of calculi, or other blood and urine test results. Logistic regression analysis revealed that geography, ethnicity, blood potassium concentration and urine volume were significantly correlated with the COD+CA component of urinary stones.3.In the univariate Logistic regression analysis, nine variables were found showing statistical significance. For the multivariate Logistic regression analysis, variables left in the model were water intake(OR=0.129, 95% CI: 0.044~0.380), preferring to drink(OR=0.161, 95% CI: 0.060~0.434), preferring to eat offals(OR=4.611, 95% CI: 2.058~10.329), preferring to eat sweets(OR=2.539, 95% CI: 1.129~5.709), sweating habits(OR=6.732, 95% CI: 2.994~15.138), eating more fruits(OR=0.372, 95% CI: 0.168~0.824), the history of the urolithiasis(OR=9.273, 95% CI: 2.622~32.797). Conclusions:1.We believe that the hot climate combined with the nutritional habits of Uyghur population significantly affects the development of pediatric urolithiasis in this ethnic group.2.There is a difference in urinary stone composition between Uyghur and Han adult patients with urolithiasis, possibly as a result of geographic distribution.3.Water quantity is less than 500 ml, eating more offals and sweets, urolithiasis history and sweating habits are the risk factors of urinary calculi while loving drinking and eating more fruits for the protection.