Renal stones in Kelantan, Malaysia--has the pattern changed?

Area of Science:

• Nephrology
• Urology
• Infectious Diseases

Background:

• Renal stones (kidney stones) are a significant health concern, particularly regarding their impact on renal function.
• Previous studies suggested regional variations in renal stone patterns and associated pathogens.
• Understanding the local epidemiology of renal stones is crucial for effective management and prevention.

Purpose of the Study:

• To retrospectively evaluate the clinical characteristics and outcomes of patients with renal stones managed at Hospital Universiti Sains Malaysia.
• To identify the common symptoms, stone locations, and associated microorganisms in this patient cohort.
• To assess the impact of renal stones on renal function and compare findings with existing literature.

Main Methods:

• Retrospective analysis of medical records of 183 patients diagnosed with renal stones between 1985 and 1995.
• Data collection included patient demographics, symptoms, stone location (upper vs. lower tract), urine culture results, and renal function status.
• Assessment of renal impairment at presentation and progression to chronic renal failure.

Main Results:

• The most frequent symptom was lumbar pain, often accompanied by urinary frequency, hematuria, or dysuria.
• Upper tract stones accounted for 88% of cases, with lower tract stones in the remainder.
• Escherichia coli was the most common pathogen isolated from urine cultures, followed by Klebsiella aeruginosa and Staphylococcus aureus.
• Nearly all patients presented with renal impairment, and 70% progressed to chronic renal failure.

Conclusions:

• The pattern of renal stones in this Malaysian region is similar to that observed in Western societies.
• Renal stones have a serious impact on renal function, with a high rate of progression to chronic renal failure.
• These findings underscore the need for increased attention to the diagnosis and management of renal stones to preserve kidney function.