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Unveiling the Burden of Nephrolithiasis in Low- and Lower-Middle Income Countries: A Review on Its Presentation, Risk Factors, Treatment Practices, and Future Directions

Background: Nephrolithiasis, or kidney stone disease, presents a significant global health burden, with global incidence rates and treatment practices varying widely. This study aims to discuss the epidemiology, risk factors, treatment modalities, and challenges for nephrolithiasis in the lower half of the World Bank rankings; that is, in low- and lower-middle-income countries.

Methods: A comprehensive literature review was conducted using PubMed for each country on the list, focusing on studies published from January 2000 onwards and reporting data on prevalence, risk factors, treatment practices, and economic implications.

Results: Nephrolithiasis represents a significant burden for healthcare systems, with noteworthy geographical variability in prevalence possibly dependent on socioeconomic status and gender. Risk factors include dietary habits, climate, pollution, and infectious diseases. Treatment practices in some regions still rely on open surgery due to limited access to advanced endourological techniques, while other regions demonstrate high proactivity in research. The burden is exacerbated by inadequate healthcare infrastructure and training.

Conclusions: Addressing nephrolithiasis in challenging economic circumstances requires targeted interventions, including improved access to modern treatment methods, enhanced training for healthcare professionals, and better socioeconomic and environmental conditions. Future research should focus on region-specific strategies and the development of sustainable healthcare solutions.

Murtadha Almusafer,1,2 Hussein Issa,3 Margarita Eleni Paraskevopoulou,4 Evangelos N Symeonidis,5 Kamran Hassan Bhatti,2,6 Mohamad Moussa,3 Athanasios Papatsoris,2,7 and Georgios Tsampoukas2,8

  1. Department of Surgery, College of Medicine, University of Basrah, Basrah 61004, Iraq
  2. U-Merge Ltd. (Urology for Emerging Countries), London 14561, UK
  3. Department of Urology, Al Zahraa Hospital, University Medical Center, Lebanese University, Beirut 2067 7201, Lebanon
  4. Medical School, Queen Mary University of London, London E1 2AD, UK
  5. Department of Urology, Faculty of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
  6. Urology Department, Hamad Medical Corporation, Doha 3050, Qatar
  7. Department of Urology, University Hospital of Athens, 151 26 Athens, Greece
  8. Department of Urology, Homerton Healthcare NHS Foundation Trust, London E9 6SR, UK
Source: Almusafer, Murtadha, Hussein Issa, Margarita Eleni Paraskevopoulou, Evangelos N Symeonidis, Kamran Hassan Bhatti, Mohamad Moussa, Athanasios Papatsoris, and Georgios Tsampoukas. 2024. "Unveiling the Burden of Nephrolithiasis in Low- and Lower-Middle Income Countries: A Review on Its Presentation, Risk Factors, Treatment Practices, and Future Directions" Société Internationale d’Urologie Journal 5, no. 5: 361-370. https://doi.org/10.3390/siuj5050055.