Introduction: Urolithiasis is a common clinical problem worldwide that involves stone formation in any portion of human urinary system by successive physicochemical events of super saturation, nucleation, aggregation and finally retention.1 Climatic conditions, dietary habits, local geology and mineral hydrology are some of the very important factors leading to incidence of renal calculi in most of the countries. A number of these causes are modifiable, like causes related to dietary habits, life style diseases, fluid intake and hardness of consumable water. Aims and Objectives: Profiling of urolithiasis patient coming to a rural hospital in the South West Rajasthan, with a wide village outreach program in terms of demography, dietary habits, co-morbidities, hardness of consumed water, site of stone in urinary tract and complications related to it. The objective is to suggest measures for
prevention and minimization of incidence and morbidity related to urolithiasis. Material and Methods: We studied 257 patients presenting to J. W. Global Hospital and Research Centre, Mount Abu, Sirohi, Rajasthan with urolithiasis during 18 months of period between September 2017 to March 2019. With their due informed consent; thorough physical examination with basic investigations (CBC, RBS, Serum Creatinine, Serum Calcium, Serum Acid, Urine examination, Abdomen Ultrasound, TDS of consumable water) done to evaluate causes of urolithiasis. Other specific investigations like urine culture and sensitivity, X-Ray KUB, CT Urogram, stone analysis etc. done on individual basis to reach definitive diagnosis. Results: Majority of the population was young with 55.2% of the patients between the ages of 18–50 years. Result showed male predominance; male and female patients were 61% and 39% respectively. Classical flank pain 57.2% and burning micturition 76.7% were the chief presenting complaints. 75.9% patients consumed less than 2.5 Litres/day water for drinking on most of the days. 51.8% consumed untreated ground water, while 48.2% consumed treated water either from government supply or water filter or after boiling the water. Water hardness, thus seems to work in association with other factors as a risk factor for urolithiasis. Conclusion: 75.9% patients consumed less than 2.5 litres water for drinking on most of the days; but drinking more than 2.5 litres of water per day couldn’t save one fourth (24.1%) of our study population from contracting urolithiasis. Excessive water intake does not seem to save you always. About half of patients 51.8% consumed untreated ground water, while 48.2% patients consumed treated water either from Government supply or their own water filter or boiling the water before consumption. In spite of the fact that untreated ground water was high in TDS (78.9% samples found to be high in TDS) and those of treated water, including government supply (only 0.02% samples found to be high in TDS), the incidence of urolithiasis in the two groups is not significantly different, indicating that the source of water has little bearing on the incidence of urolithiasis. However, if we ignore the source of water, The TDS level of consumed water in 60.3% of our population was in the high range, while rest consumed soft water. Water hardness, thus seems to work in association with other factors as a risk factor for urolithiasis.
Keywords: Urolithiasis; Water Hardness Diet; Water Intake; South-West Rajasthan.
Original Article
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