The authors studied the features of
urolithiasis in three different geographical regions: Moscow, the Kirghiz SSR, and Berlin from the findings of examination of the composition and structure of uroliths removed by operation or passed spontaneously, (602 concrements from Moscow, 10,000 from Berlin, and 127 from Kirghizia). X-ray diffraction measurement, infrared spectrophotometry, and polarizing microscopy were conducted to analyze the composition and structure of the stones. Complex biochemical examination was carried out in patients from Moscow and Kirghizia. According to the results of the study, the following features of
urolithiasis are common in the studied regions: (1) prevalence of
oxalate lithiasis on the whole, which points to the principal role of metabolic factors in lithogenesis; (2) approximately similar amounts of
apatite carbonate crystals in the uroliths; (3) certain similarity in composition of concrements from Berlin and Kirghizia. The most essential differences are: (1) the frequency of renal
oxalate stones is highest in Berlin and lowest in Moscow. The prevalent types of
calcium oxalate stones are:
whewellite of concentric structure (linked with
hyperuricemia) in Kirghizia;
whewellite of small randomly orientated crystals (linked with
hypercalciuria) and stones with signs of transformation of
weddellite to
whewellite in Moscow; (2) lesser distribution of
phosphate lithiasis in Berlin than in Kirghizia and particularly in Moscow. Prevalence of
struvite crystals in stones from Moscow, the formation of which is linked with the vital activity of Proteus and E. coli; (3) higher distribution of
urate lithiasis in Moscow and particularly in Kirghizia where significant metabolic risk factors of lithogenesis were revealed.