The pattern of urinary stone disease varies widely throughout the Middle East in terms of prevalence, site of formation, stone composition, diet, and urinary risk factors. In the developing countries, whose economies are still largely based on agriculture, ammonium urate-containing bladder stones in children are still a frequent finding, although this form of the disorder is decreasing with improving nutritional standards. In the more affluent Gulf states upper urinary tract stones in adults are extremely common—the life-time prevalence in men over the age of 60 being greater than 20%, the highest in the world. In these patients, the stones are composed mainly of calcium oxalate and/or uric acid. Calcium phosphate-containing calculi and infection stones are relatively uncommon. The high prevalence of calcium oxalate and uric acid stones can be attributed to the low urine volumes, more acid urines, hyperuricosuria, hypocitraturia, and extensive mild hyperoxaluria which are common in the region. These urinary abnormalities are due to the consumption of a diet over-rich in animal protein, purine, and oxalate but low in calcium. Addition of 1g/day calcium to the diet reduces urinary oxalate to normal without any major increase in urinary calcium.
KeywordsCitrate Syria Turkey Oxalate Purine
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