2nd February 2018, Volume 131 Number 1469

Stephanie Loeff, Manmeet Saluja, Michael Rice

Acute urolithiasis can be an extremely disabling condition and represents a substantial proportion of everyday urology practice. The incidence of urolithiasis has increased both within New Zealand and globally over…

Subscriber content

The full contents of this page is only available to subscribers.

To view this content please login or subscribe

Summary

Decreasing incidence of symptomatic stones which could be attributed to a large influx of Asian immigrants. A male aged 40–49 with a past history of stones has the highest chance of stone formation.

Abstract

Aim

To evaluate the incidence of acute symptomatic urolithiasis in the Auckland region. Associated epidemiological factors and stone characteristics were also studied and compared to previous research conducted in order to analyse trends.

Method

All patients that presented acutely with symptomatic urolithiasis to the Auckland District Health Board (AHDB) between July 2014 and June 2015 were studied. Clinical data was obtained from medical records and population data was based on estimates provided by the Ministry of Health. Two-tailed tests and the Pearson Chi-Square tests were used for analysis.

Results

Overall, 1,125 patients (1,328 events) presented with an incidence of 85 per 100,000 per year, which was lower than that reported in 2006. The highest incidence was found among the Middle Eastern ethnic subgroup (0.130 %), followed by Māori (0.102%), Asian (0.087%), European (0.084%) and Pacific (0.041%) ethnicity. Males were more likely to be affected than females. Urolithiasis was most common in the fifth decade of life (25%). Forty-seven percent of the study population presented with multiple stones and 64% had recurrent urolithiasis or were ‘high risk’ stone formers. Distal ureteric stones <5mm were the most common (27%). Urine cultures were positive in 16% of cases. Seven hundred and thirty-nine (57%) were managed with medical management and ureteroscopy was most commonly performed for those who needed surgical intervention.

Conclusion

The overall incidence of urolithiasis has decreased compared to previous research conducted in Auckland. This deviation could be attributed to the large influx of Asian immigrants observed in this period of time. A caucasian male, between 40–49 years, with a calculus <5mm in the distal ureter with a history of a previous urolithiasis has the highest chance to present with renal colic.

Author Information

Stephanie Loeff, Auckland Hospital, Auckland; Universitair Medisch Centrum Groningen, the Netherlands; Manmeet Saluja, Auckland Hospital, Auckland;
Michael Rice, Auckland Hospital, Auckland.

Acknowledgements

Dr Roger Chambers, B Rong Hu.

Correspondence

Michael Rice, Urology, Auckland Hospital, Auckland.

Correspondence Email

mrice@adhb.govt.nz

Competing Interests

Nil.

References

  1. Du J, Johnston R, Rice M. Auckland, New Zealand Temporal trends of acute nephrolithiasis. N Z Med J. 2009 Jul 24; 122(1299):13–20.
  2. Davidson PJ, Sheerin IG, Frampton C. Renal stone disease in Christchurch, New Zealand . Part 1 : Presentation and epidemiology THE NEW ZEALAND presentation and epidemiology. N Z Med J. 2009 Jun 19; 122(1297):49–56.
  3. Scales CD, Smith AC, Hanley JM, Saigal CS. Prevalence of kidney stones in the United States. Eur Urol. 2012; 62(1):160–5.
  4. Nowfar S, Palazzi-churas K, Chang DC, Sur RL. The Relationship of Obesity and Gender Prevalence Changes in United States Inpatient Nephrolithiasis. Urology. 2011 Nov; 78(5):1029–33.
  5. Taylor EN, Stampfer MJ, Curhan GC. Diabetes mellitus and the risk of nephrolithiasis. Kidney Int.2005; 68:1230–5.
  6. Besiroglu H, Otunctemur A, Ozbek E. The metabolic syndrome and urolithiasis: a systematic review and meta-analysis. Ren Fail. 2015 Feb; 37(1):1–6.
  7. 2013 Consensus, Statistics New Zealand. [Internet] Available from http://www.stats.govt.nz/Census/2013-census/profile-an place.aspx?request_value=13170&tabname=Culturaldiversity
  8. Rule AD, et al. The ROKS Nomogram for Predicting a Second Symptomatic Stone Episode. J Am Soc Nephrol. 2014 Dec; 25(12):2878–86.
  9. Turk C, et al, EAU Guidelines on Diagnosis and Conservative Management of Urolithiasis. Eur Urol. 2016 Mar; 69(3):468–74.
  10. Turney BW, et al. Diet and risk of kidney stones in the Oxford cohort of the European Prospective Investigation into Cancer and Nutrition (EPIC). Eur J Epidemiol. 2014 May; 29(5):363–9.
  11. Piazza PFR, Bisi NGM, Ferrari GGG. Lithiasis and Risk Factors. 2007; 79(suppl1):8–15.
  12. Milose JC, Kaufman SR, Hollenbeck BK, Wolf JS Jr, Hollingsworth JM. Prevalence of 24-hour urine collection in high risk stone formers. J Urol. 2014 Feb; 191(2):376–80.
  13. Turk et al, EAU Guidelines on Diagnosis and Conservative Management of Urolithiais. Eur Urol. 2016 Mar; 69(3):468–74.

Download

The downloadable PDF version of this article is only available to subscribers.

To view this content please login or subscribe