Differences in Urinary Calculi Characteristics among the Three Main Racial Groups in KwaZulu-Natal, South Africa

Dhesigan Naidoo, V. Ramloutan
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Abstract

Racial differences in the characteristics of urinary calculi are poorly described in the South African context, limiting our local understanding of urolithiasis pathology and thwarting our efforts in designing appropriate preventative interventions. We sought to investigate differences in urinary calculi characteristics among the main racial groups in KwaZulu-Natal, South Africa. We conducted a retrospective chart review of patients with urinary calculi at a quaternary hospital in KwaZulu-Natal, South Africa, during 2018–2019. We collected data on the patient’s age, sex, race (Caucasian, Asian, Black African), residence, and pre-stenting. Five study outcomes were investigated across racial groups: number of calculi, location of the calculi, size of the calculi, density of the calculi (Hounsfield Unit measurement >600), and the number of operative interventions performed. Data were analyzed with descriptive statistics, the chi-squared test, and unadjusted/adjusted logistic regression. Our study sample consisted of 147 patients (10.9% Caucasian, 55.8% Asian, and 33.3% Black African). Most patients (86.4%) were from urban areas. A higher proportion of Black Africans had urinary calculi with Hounsfield Unit measurements >600 (P = 0.002). In the logistic regression models, Black Africans had a higher probability of having urinary calculi with Hounsfield Unit measurements >600 (Unadjusted Odds Ratio: 7.17, 95% Confidence Interval: 2.00–27.80; Adjusted Odds Ratio: 18.75, 95% Confidence Interval: 3.37–157.57). Our analysis suggests that Black Africans are at higher risk of having harder urinary calculi than other race groups. This has implications for urolithiasis management and highlights the importance of primary prevention in this group. We recommend additional research to confirm our findings.
南非夸祖鲁-纳塔尔省三个主要种族尿路结石特征的差异
在南非的背景下,尿路结石特征的种族差异描述得很少,这限制了我们对尿路结石病理的当地理解,并阻碍了我们设计适当的预防干预措施的努力。我们试图调查南非夸祖鲁-纳塔尔省主要种族群体尿路结石特征的差异。我们对2018-2019年南非夸祖鲁-纳塔尔省一家第四医院的尿路结石患者进行了回顾性图表回顾。我们收集了患者的年龄、性别、种族(高加索人、亚洲人、非洲黑人)、居住地和支架植入前的数据。五项研究结果跨种族进行了调查:结石数量、结石位置、结石大小、结石密度(Hounsfield单位测量值>600)和手术干预次数。数据分析采用描述性统计、卡方检验和未调整/调整logistic回归。我们的研究样本包括147例患者(10.9%高加索人,55.8%亚洲人,33.3%黑非洲人)。大多数患者(86.4%)来自城市地区。豪斯菲尔德单位测量值>600的非洲黑人尿路结石比例较高(P = 0.002)。在logistic回归模型中,黑人非洲人患尿路结石的概率较高,且Hounsfield单位测量值>600(未经调整的优势比:7.17,95%置信区间:2.00-27.80;校正优势比:18.75,95%可信区间:3.37-157.57)。我们的分析表明,非洲黑人患硬性尿路结石的风险高于其他种族。这对尿石症的管理具有启示意义,并强调了初级预防在这一群体中的重要性。我们建议进行更多的研究来证实我们的发现。
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