CLINICO-EPIDEMIOLOGICAL STUDY OF URINARY CALCULI AND ITS BIOCHEMICAL ANALYSIS

Dr. Prakash Gurav, Dr. Santosh Dalavi and Dr. Anand H. D.*

ABSTRACT

Introduction: Urolithiasis represents a major problem met within urological practice. Urinary calculi are the third most common affliction of the urinary tract, exceeded only by UTI and pathological conditions of prostate.[1] It is estimated that up to 5% of the world population is affected by this disease and the lifetime risk of getting urinary stone is 8-15%. Of course, this data varies from region to region depending upon the local climate and dietary habits of the local population. Even more so, fifty percent of patients will have recurrent stone disease within 5 years, so it can be considered a disease for life.[2] The knowledge of chemical composition of Urinary calculi may be of great importance both as a guide for the clinical management of urinary calculi and also for better understanding of physicochemical principles underlying the calculi formation that may help to give advice and suggestions for the people and educate patients to carry out preventive measures in reducing the risk of prevalence and mainly to lower the chance of recurrence of urolithiasis in this region. Primary Objective: To study the clinical profile of Urinary calculi and its biochemical analysis. Secondary Objective: To study the aetio-pathology of urinary calculi in this region and the management of urinary calculi. Methods: After admission to the hospital, a detailed clinical history and examination of the patient was done as per proforma. Routine blood and urine investigations were done. Specific investigations to confirm the diagnosis of Urolithiasis like CT IVP. Depending on the size and site of the calculus, the appropriate treatment for the patient will be decided. The treatment included both medical as well as surgical management. Among surgical management the procedures observed were Nephrolithotomy, Pyelolithotomy, URS guided lithotripsy, Cystolithotripsy and cystolithotomy. The calculi extracted from patients were analyzed by wet chemical method for composition of urinary calculi. Observations and Results: Renal calculus was the most common overall comprising 33.33% of total study subjects. Majority of the (90%) study subjects were consuming predominantly non vegetarian diet with staple diet being wheat more than rice. Urinary tract infection is the most commonly associated genito urinary disease in patients of urolithiasis found in 64.8% of study subjects. 88% of calculi were casting shadow on plain radiograph. 33.33% of study subjects urine was positive for calcium oxalate crystals which was found most commonly n this study, and other crystals identified on urine microscopy being struvite crystals and Urate crsytals. The commonest organism was E coli, next to E coli commonest were K. Aerogenosa, Staphylococci, Pseudomonas and Proteus Mirabilis. that Calcium was the most common basic radical and Oxalate was the most common acidic radical. Overall calcium oxalate and Phosphate stones(92.51%) were most common in our study, followed by uric acid stones(68.5%) and magnesium ammonium phosphate stones(33.33%). Conclusion: Dietary habits being an important etiological factor has not been studied in detail, so more studies should be taken up to analyze relationship between diet and urolithiasis in respective geographical areas. Urinary calculi analysis should be done on routine basis in every case of urolithiasis and based on composition dietary and lifestyle advices should be given to patient in order to prevent recurrences.

Keywords: Urolithiasis, Biochemical analysis, Prevention, Recurrence.