Prevalence and predictors of incidence of urolithiasis in a representative region

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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 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.

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About the authors

Olga S. Streltsova

Privolzhskii Research Medical University

Author for correspondence.
ORCID iD: 0000-0002-9097-0267
SPIN-code: 9674-0382

Dr. Sci. (Med.), Professor of the E.V. Shakhov Department of Urology

Russian Federation, Nizhny Novgorod

Valentin N. Krupin

Privolzhskii Research Medical University

ORCID iD: 0000-0002-4887-4888
SPIN-code: 8892-7661
Scopus Author ID: 7003284228

Dr. Sci. (Med.), Professor, Head of the E.V. Shakhov Department of Urology

Russian Federation, Nizhny Novgorod

Valery F. Lazukin

Privolzhskii Research Medical University

ORCID iD: 0000-0003-0916-0468
SPIN-code: 3400-9905

Cand. Sci. (Biol.), Associate Professor of the Department of Medical Physics and Informatics 

Russian Federation, Nizhny Novgorod

Dmitry P. Pochtin

N.A. Semashko Nizhny Novgorod Regional Clinical Hospital



Russian Federation, Nizhny Novgorod

Vasif D. Khalili

Privolzhskii Research Medical University

ORCID iD: 0000-0002-2793-4407

Clinical Resident of the E.V. Shakhov Department of Urology

Russian Federation, Nizhny Novgorod

Elvira A. Manakova

LLC “Centralized Laboratory AVK-Med”


Director for Medicine, LLC “Centralized Laboratory AVK-Med”

Russian Federation, Nizhny Novgorod


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Supplementary files

Supplementary Files
1. Fig. 1. Average annual number of admissions of patients with urolithiasis (nosologies N20.0, N20.1, N20.2) per 10,000 populations in the Nizhny Novgorod Region. № 6 — city K., № 49 — city V.

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2. Fig. 2. Relative frequency of treatment of patients with nosological unit N20.0 (kidney stones) (a), N20.1 (ureteral stones) (b), and N20.2 (kidney and ureteral stones) (c) in regional hospitals and local medical institutions

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3. Fig. 3. Sources of water consumed by the residents of the Nizhny Novgorod Region (n = 800)

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4. Fig. 4. Indicators of groundwater hardness and frequency of requests for urolithiasis depending on the category of districts

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5. Fig. 5. Mineralogical composition of stones from patients with urolithiasis (n = 1000): a, calcium oxalate monohydrate; b, calcium oxalate dihydrate; c, hydrophosphate-calcium carbonate; d, magnesium ammonium phosphate; е, ammonium urate

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