Epidemiology of stone disease in Saudi Arabia with an overview of the regional differences

Abstract

In Saudi Arabia, urolithiasis is an upper urinary tract disease with predominance of calcium oxalate and uric acid/urate stones. The environmental temperature is high and water intake inadequate. Stone patients have low urinary volume, pH, and calcium, but high oxalate and urate excretion. Endemic bladder stones have disappeared. Lifetime risk of a stone episode is 50 times higher than in the West. Stones are predominantly calcium oxalate (82 %) all urate/uric acid (11.5 %). Phosphate stones are only found in 5.8 %. Die is rich in purine and oxalate; hyperoxaluria, hypocalciuria, and hypouricosuria are common. While diabetes is seen in 25�30 % of the population, the linkage with stone disease has not been examined. In Iraq, bladder stones are seen in 15 %. In Jordan, 17.7 % are calcium phosphate. In Iran and Turkey, patients have a strong family history of stones. In Iran the gender ratio is low (1.15:1 as compared to 4:1). A metabolic cause is found in 75 % of pediatric patients.