Prevalence and predictors of incidence of urolithiasis in a representative region

BACKGROUND: Domestic and foreign studies have shown the presence of correlations between the prevalence of urolithiasis, anthropogenic factors, and composition of the water consumed by the population. In the Nizhny Novgorod Region, there is a high incidence of urolithiasis; thus, the identification of its causes appears to be an urgent task. AIM: To assess the prevalence and identify predictors of the incidence of urolithiasis in the rural population of the Nizhny Novgorod Region. MATERIALS AND METHODS: The study was conducted in the Nizhny Novgorod Region. Annual reports of patients seeking medical care for urolithiasis for 3 years in 49 central district hospitals and two large regional hospitals were analyzed. The incidence rate of urolithiasis was calculated according to the treatment of patients with urolithiasis also for 3 years in relation to the population of each district. Information about drinking sources was obtained by questioning 800 patients with urolithiasis who were treated at the Nizhny Novgorod Regional Clinical Hospital. The chemical composition of drinking water was assessed in accordance with the requirements for drinking water SanPiN 2.1.4.1074-01. The mineralogical composition of 1000 urinary stones of patients from rural areas of the Nizhny Novgorod Rregion was retrospectively analyzed using a Nicolet iS5 IR-Fourier spectrometer. RESULTS: In this study, 38 (77.5%) districts of the Nizhny Novgorod Region have unfavorable conditions for urolithiasis. Moreover, 59.5% of the rural population are using water from underground sources (wells). Significant correlations were found between the incidence of urolithiasis and the chemical composition of the water consumed, particularly water hardness. The analysis of the mineralogical composition of urinary stones showed their polycomponent composition in 89.5% of the cases. Differences in the chemical composition of stones are associated with the environmental factors of the region, one of which is drinking water. CONCLUSIONS: Most of the rural population of the Nizhny Novgorod Region is at risk for urolithiasis. Significant differences in the incidence of urolithiasis were dependent on the degree of hardness of the groundwater used for drinking. Increased water hardness is a significant risk factor for the development of urolithiasis.