Nephrolithiasis

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Nephrolithiasis is the third most common problem of the genitourinary system.

Kidney stones are a prevalent condition worldwide, with an incidence of about 12% of the population (Alelign & Petros, 2018). Causes of kidney stones are multifactorial; they include physiochemical events such as “supersaturation, nucleation, growth, aggregation, and retention of urinary stone constituents within tubular cells” (Alelign & Petros, 2018). The most common type of kidney stone consists of calcium oxalate and forms on the renal papillary surface at the Randall’s plaque (Alelign & Petros, 2018).

Identify and discuss risk factors for kidney stones including cultural considerations

According to Shin, Srivastava, Alli, & Bandyopadhyay (2018), urolithiasis risk factors “can be divided into four major categories: dietary, genetic, environmental, and lifestyle.” Most patients presenting with urolithiasis are age 43 or older (Shin, Srivastava, Alli, & Bandyopadhyay, 2018).  First-time occurrence is more prevalent in women, while recurrence is more prevalent in men (Alelign & Petros, 2018). It is believed that diet is a contributing factor in the increment of urolithiasis cases in women, which in recent years have increased significantly (Shin, Srivastava, Alli, & Bandyopadhyay, 2018). Although there is no relationship between the prevalence of urolithiasis and race, recent studies indicate white adults have a higher risk in comparison with black adults (Shin, Srivastava, Alli, & Bandyopadhyay, 2018).

Other risk factors include obesity, sedentarism, comorbidities such as hypertension, type II diabetes, and chronic kidney disease (Shin, Srivastava, Alli, & Bandyopadhyay, 2018). Micronutrients found in the diet also contribute to the formation of kidney stones (Shin, Srivastava, Alli, & Bandyopadhyay, 2018). Sodium, calcium, and oxalate are significant components of kidney stones, while magnesium, potassium, and citrate help in the prevention or the treatment of urolithiasis (Shin, Srivastava, Alli, & Bandyopadhyay, 2018). Another risk factor within the diet is the excessive consumption of animal protein (Shin, Srivastava, Alli, & Bandyopadhyay, 2018). Metabolized amino acids, transform into oxalate, one of the main components of kidney stones (Shin, Srivastava, Alli, & Bandyopadhyay, 2018).

Environmental risk factors include higher temperatures and humidity, which can lead to dehydration, thus resulting in the formation of kidney stones (Shin, Srivastava, Alli, & Bandyopadhyay, 2018). Exposure to hazardous material such as cadmium and melamine may also be a precursor of the conditions (Shin, Srivastava, Alli, & Bandyopadhyay, 2018). When it comes to genetic factors, although there is no genetic predisposition for urolithiasis, familial history of the condition seems to be related to comorbidities that can be pass on and result in kidney stone formation (Shin, Srivastava, Alli, & Bandyopadhyay, 2018).

In the United States, migration has a direct impact on the results regarding the percentage of people affected by urolithiasis. It is believed younger, and better fit people migrate to the United States, thus causing a skewed results in the statistics (Shin, Srivastava, Alli, & Bandyopadhyay, 2018). High intakes of process food in addition to sedentary lifestyles, place the population at a higher risk when compared to other populations with contrasting lifestyles (Shin, Srivastava, Alli, & Bandyopadhyay, 2018). In my opinion, significant changes in modifiable risk factors such as diet and exercise, as well as prevention of comorbidities may reduce the incidence of urolithiasis in the United States.

References

Alelign, T., & Petros, B. (2018). Kidney Stone Disease: An Update on Current Concepts. Advances in urology2018, 3068365. doi:10.1155/2018/3068365

Shin, S., Srivastava, A., Alli, N. A., & Bandyopadhyay, B. C. (2018). Confounding risk factors and preventative measures driving nephrolithiasis global makeup. World journal of nephrology7(7), 129–142. doi:10.5527/wjn.v7.i7.129

 
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