[Clinico-epidemiologic behavior of urolithiasis in a rural Caribbean region].Arch Esp Urol 2002; 55(5):527-33; discussion 533-4AE
The aim of this clinicoepidemiologic study is to determine the frequency, risk factors, morbidity and socioeconomic impact or urolithiasis in the general population of a Caribbean, subtropical rural area.
A representative sample of 1,504 subjects were randomly selected from the general population of 15,591 inhabitants in the area whose health services were provided by the Policlinico Julio Trujillo using the two-stage and equal probability functions with 95% CI. After informed consent was obtained, a survey was conducted to identify the subjects in the sample that had developed urolithiasis at some time or another. All subjects with a history of urolithiasis were included in a second survey to obtain the data required to complete the study.
The prevalence rate was found to be similar to the 2.52% prevalence estimated worldwide. Urolithiasis was more common in the 20-29 years age group for both genders, and prevalent in the caucasians (3.2%) and male gender (3.2%). 36.8% of the subjects that had developed urolithiasis at some time or another had a family history of urolithiasis. Urinary tract infection, arterial hypertension, ischemic heart disease and diabetes mellitus were frequently associated with this condition. The incidence of stone formation was higher for the hottest period. High intake of food rich in oxalic acid, carbohydrates, proteins-purines and dairy products and low intake of fluids were closely linked with lithiasis. 97.2% s had one and 78.3% had more than one episode of nephric colic. 68.4% had one and 61.5% more than one recurrence of urolithiasis. 15.7% required surgery and 42.1% required hospitalization. Only 42.1% of the cases had unspecific medical treatment. No case had specific treatment.
The behavior of urolithiasis in this rural population is the same as that reported in other studies for urban areas. It showed a high frequency, similar risk factors, high morbidity and important socioeconomic impact. Only half of the patients received treatment that is considered to be the least costly.