Exploring the Impact of Family History, Demographics and Ecological Factors on Urolithiasis Prevalence: Insights from a Nationwide Study.

Objective:  This study aimed to evaluate the potential risk factors of lifetime urolithiasis occurrence on a nationwide scale in Iran.

Methods:  All data regarding urinary stone events were extracted from the cross-sectional Iran National Stone Survey (INSS) study, and the possible determinants of urolithiasis incidence were evaluated.

Results:  Our multivariable logistic regression suggested that while older age at presentation, male sex, and a positive family history of urolithiasis in either of the patient's parents or siblings were all significantly associated with an increased odds of lifetime urolithiasis occurrence (all P < .001), a positive family history in one's sister (odds ratio; OR=5.56) or brother (OR=4.70) were the most significant predictors. Moreover, belonging to Baluch ethnicity (i.e., an ethnical group indigenous to the south eastern regions of Iran) and residing in regions with higher water hardness (i.e., total concentration of dissolved minerals) were also associated with an increased odds of urolithiasis occurrence (P < .001 and P=.023, respectively). Conversely, living in regions with higher mean humidity decreased the chances of developing a urinary stone event during one's lifetime (OR=0.62, P <.001).

Conclusion:  Our results indicated that a constellation of demographic, ecological, and familial risk factors are associated with an elevated risk of developing urinary stones during one's lifetime. These findings can assist in implementing novel regional healthcare policies, considering the specific demographic and ecological characteristics. They also support tailoring personalized preventive strategies, particularly for individuals with multiple nonmodifiable risk factors.