Urolithiasis and water intake in Saudi Arabia, is it a matter of quality or quantity?

Introduction: Urolithiasis is a significant problem with an increasing incidence and prevalence worldwide. Multiple factors such as water intake, climate change, dietary habit, and genetic factors can affect stone formation. Our aim is to clarify the relationship between water intake and urolithiasis in Saudi Arabia as a hot climate area. Methods: This cross-sectional internet-based survey was conducted in November 2017. Our study was performed using a standard web-based questionnaire using social media open to all internet users. We excluded the incomplete responses. Analysis of the data was then carried out using Chi-square test and SPSS package version 20. Results: We found a great response to our survey, where 9100 participants responded. Among the participants, 76.6% were females and 23.4% were males. The largest age group was between 18 and 30 years (60.8%). Of the participants, 842 (9.3%) had history of urinary tract stones. About 74.3% of the participants with a history of urinary tract stones were drinking <1 L/day of water in comparison with those who had no history of urinary tract stones who were drinking a minimum of 1.25 L/day in 55.1%. Regarding the type of water intake, there was no significant relationship between the type of water and the incidence of stones formation (P =0.096). The amount of water was significantly correlated with the urolithiasis (P = 0.000). Conclusion: We concluded that the amount of water intake per day significantly correlated with urolithiasis, and according to our study, the minimally accepted intake was ≥1.25 L/day. However, the type of water consumed has no statistically significant impact on stone formation.

Different managements of horseshoe kidney stones, any difference in the outcome?

PURPOSE: The aim is to assess the outcomes of different approaches for the management of renal stones associated with horseshoe kidneys (HSKs) in our institution over a 12-year period. METHODS: A retrospective review of 144 patients with HSKs who presented from 2000 to 2012 was performed. Twenty-eight patients (19.4%) were found to have renal stones. Demographic data were collected; the method of treatment and the outcomes of stone management were reviewed. We excluded patients with non-functioning moieties and associated genitourinary anomalies, and those with incomplete data. RESULTS: We included 25 patients, of which 16 males (64%) and 9 females (36%), with a mean age of 37 years. Mean serum creatinine level was 66 mmol/L. Eleven patients with a stone size <8 mm were treated expectantly with medical treatment, with only one patient requiring endoscopic intervention. Six patients (24%) with a stone size between 1 cm and ≤2 cm were treated with extracorporeal shock wave lithotripsy (ESWL) with the placement of double J stents, and seven patients (28%) with a stone size of >2 cm were treated with percutaneous nephrolithotomy. One patient with a 10 mm stone was treated using flexible ureteroscopy. No significant perioperative complications were encountered. CONCLUSIONS: Indications, methods of treatment, and outcomes of management of stones associated with HSKs were comparable to those for stones associated with normal kidneys. Tailored approach based on stone size is highly recommended. ESWL accompanied with ureteric stenting is a promising strategy for the management of stones associated with HSKs in selected patients requiring intervention.