Trends in the prevalence of the metabolic types of urolithiasis in Moscow region: comparative analysis for a period of 2010-2013

We have investigated the chemical composition of 5 669 urinary stones in 2 413 male and 2 429 female patients with urolithiasis with the age of 16 to 74 years, which were treated in the Federal State Scientific Institute of Urology and City Hospital 47 in a period from 2010 to 2013. Inhabitants of Moscow accounted for 61.5% of cases, inhabitants of Moscow region - for 15.5% and patients from other regions - for 23.0% of cases. Comparative analysis was carried out with regard to the chemical composition of the stones in the preceding period (1985-2009). It was shown, that oxalate urolithiasis was the dominant form of urolithiasis in the last 4-year period with a decrease trend to 56.8% in the structure. Uric acid urolithiasis and phosphate urolithiasis have demonstrated a rising trend up to 17.4% and 24.9%, correspondingly, in comparison with period of 1990-2009. The prevalence of the presence in mixed stones for calcium oxalate was shown to grow from 39% (1985-1989) up to 73.8% (2010-2013). Carbon apatite-oxalate was shown to be a frequent component of urinary stones since 1990 up to 2013, which points at the important role of this apatite component in the genesis of oxalate stones, particularly in the initiation of heterogeneous mechanism of the nucleation during the crystal formation. This data reflects some peculiarities of the pathogenesis in oxalate urolithiasis and could be tightly connected to the observed progression of calcium-oxalate urolithiasis in industrially developed countries. Uric acis urolithiasis showed the tendency to a growth at 14.5% with a parallel growth of phosphate urolithiasis at 32.4%. During the last decades (1990-2013) male patients demonstrated a high prevalence of urate urolithiasis (16.5%-18.4%), female patients - of phosphate urolithiasis (24.5-33.4%). At that, it could be shown, that uric acid urolithiasis tends to grow in women (up to 16%), which is probably connected to the nutritional changes. The results obtained could be used for the development and realization of specialized clinical programs in the area of urolithiasis aimed at prophylaxis and treatment, and also for the audit of the efficacy of already conducted actions to decrease the urolithiasis morbidity.