Study: Indo-Trinis more prone to kidney stones

Not only do kidney stones negatively affect a patient's quality of life, but TT citizens of East Indian descent are more likely to develop the condition.

This is according to one of three studies done locally within the last three years by a team led by Dr Satyendra Persaud, Dr Arista Maharaj and colleagues from UWI.

The study, Quality of Life Among Stone Patients with Urolithiasis (kidney stones) in Trinidad, looked at adults at the Urology Department at the San Fernando General Hospital, along with matching controls. It assessed subjects on the basis of the Wisconsin Stone Quality of Life questionnaire from January-August 2023. Of the 310 participants, 170 were kidney-stone formers and 140 controls. It found the average age of stone-formers was 50.5, with 51 per cent being male. It also found that 77 per cent were of East Indian descent.

Persaud said this aligns with trends doctors have been noticing on the wards. "East Indians, in general, are at a higher risk of stone formation," Persaud told Newsday."We don't know why. It might be genetic or it might be cultural, it might have to do with diet." The study also found younger patients, particularly females, and those with larger stones had poorer outcomes.

Unsurprisingly, the study found those with stones had a lower quality of life than those without. Persaud said this is primarily because of the physical pain.

"People who have given birth and who had kidney stones say that kidney-stone pain is worse," he said. "(It causes) a significant degree of anxiety (and) depression. It affects them physically.

"You can lose a kidney potentially from kidney stones, you can lose both kidneys, and you can damage one kidney or both from kidney stones. You can require multiple surgeries so you miss work. It can affect your ability to work."

But there is light at the end of the tunnel. The study also found medical interventions can lead to significant improvement in a patient's quality of life. "We looked to the stone-formers who then went on to have surgery. We removed all of the stones, and those people who had surgery, their quality of life improved at one month after surgery," he said."What we proved is, not only are kidney stones common, but (they) impair your quality of life."The prevalence study was a self-reported survey with 1,219 respondents. Of these, 16.74 per cent said they were currently affected by kidney stones confirmed by imaging. It also found 34 per cent of respondents had had kidney stones previously, and 33.8 per cent had a family member who suffered from the condition.

Persaud noted one limitation of this study, which was solicited from the general public via social media, is that respondents with interests in the condition would be most likely to respond.

Despite this, he said, the incidence of those currently suffering from kidney stones was still high.

A 2017 study found the condition's prevalence ranged from seven-13 per cent in North America, five-nine per cent in Europe, and one-five per cent in Asia.

The study on healthcare costs logged all stone-related events at the San Fernando General Hospital for a month. It included emergency visits and admissions, outpatient visits and surgical procedures. Costs were calculated from figures obtained from the hospital's Costing Unit. It estimates that treating kidney stones costs the hospital $11,904,124.44 (US$1,750,606.50) annually.

Overall, he said these studies are just a start in showing the importance of the condition and the need for more targeted approaches to combating it.

"We need more education on how to go about preventing kidney stones...just like how you have these diabetes outreaches, or the diabetes education, we should be having education on how to prevent kidney stones," he said.

He said the public has numerous misconceptions about the condition.

There also needs to be additional investment in managing and treating it, particularly in technology. "I don't want to come off like the Government is not investing in kidney-stone management, but we need even more investment in technology to effectively manage these stones," he said.

Persaud said he procedure to remove kidney stones includes the use of small cameras, scopes which are passed into the bladder and up the ureters.

"So it's very technology-dependent. You need lasers, you need guidewires, you need baskets to grab stones.

"We need investments in this technology. There are already investments, but we need even more."

The studies were presented at the Caribbean Urological Association's (CURA) annual general meeting earlier this month at the Hyatt Regency Hotel. Persaud is a consultant urologist at the San Fernando General Hospital, a urology lecturer at UWI and the current president of
CURA.