Presented by: Mario Basulto-Martinez MD, MSc
Western University Schulich School of Medicine & Dentistry

Introduction

Mexico holds the second highest population in both North America and Latin-American. Mexico’s population, however, is remarkably underrepresented on the mainstream scientific literature on urinary stone disease (USD). We aimed to gather and systematically review the literature on USD prevalence and risk factors in Mexico including grey literature and Official Data.

Materials

The dataset from the 2018 Health and Nutrition National Survey (HNNS) data was reviewed. In addition, we screened English and Spanish literature on USD prevalence and risk factors from Mexico since 2012, including grey literature. The resulting manuscripts were systematically appraised. This is a PRISMA statement compliant study.

Results

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The HNNS included 43,070 participants nationwide and USD prevalence per 1,000 persons was 33.2, with Yucatan state and Mexico City holding the highest prevalence (72.2 and 61.5, respectively). The Gulf Coast had the highest burden of USD (Figure 1). Median age was higher for SF (p<0.0001]) and peak age-prevalence was 60-70 years (49.6). Moreover, 11 manuscripts reporting 2791 stone-formers (SF) and 112 non-stone-formers (NSF) controls were included for review. 

Obesity [1.69 (1.51 – 1.89), p<0.0001], Type 2 diabetes (T2D) [1.68 (1.45 – 1.94), p<0.0001] and hypertension (HTN) [2.04 (1.82 – 2.29), p<0.0001] were associated with USD.  Obesity rates in SF ranged from 33 - 62.7% and extracted data from manuscripts reporting T2D and HTN rates in SF was 23.1% and 27.5%, respectively. Menopause was not associated with USD [0.76 (0.57 – 1.01), p=0.061]. The most frequent metabolic abnormalities were hypocitraturia (39.4 – 98%), hypercalciuria (21.3 – 42.1%), hyperoxaluria (31 – 36.5%) and hyperuricosuria (13.1 – 26.6%).

Conclusion

USD literature in Mexico is scarce. The Gulf Coast holds the highest prevalence with 1 in every 13 persons, similar to that reported in North America (7-13%) and Europe (5-9%). Obesity, T2D and HTN are significant risk factors, and hypocitraturia was the most frequent metabolic abnormality.

Funding

None

Lead Authors

Eduardo Gonzalez-Cuenca, MD, MSc
Western University Schulich School of Medicine & Dentistry

Co-Authors

John Denstedt, MD, FRCSC, FACS, FCAHS
Western University Schulich School of Medicine & Dentistry