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 tone 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.