Rising prevalence of uric acid urolithiasis in Taiwan: A retrospective cohort study with an Asia-Pacific perspective

Purpose: Urolithiasis affects nearly 10% of the global population and exhibits significant geographic variability. Despite its prevalence, there is limited research on changes in stone composition over time. This study investigates the clinical characteristics and epidemiological trends of urolithiasis in Taiwan from 2010 to 2018 and synthesizes evidence on temporal changes in stone composition across the Asia-Pacific region, including Japan, China, South Korea, Thailand, and India. Materials and methods: This retrospective cohort study analyzed data from 1364 patients with urolithiasis, either spontaneously passed or collected surgically, from July 2010 to March 2018. Patient demographics and stone compositions, determined by Fourier-transform infrared spectroscopy, were collected. Relevant nationwide studies in the Asia-Pacific region were identified to investigate changes in stone composition over time. Results: Of the 1364 patients, 75% were male, and the mean age was 53.5 years. Calcium oxalate stones were the most common (53.3%), followed by calcium phosphate (27.6%) and uric acid (UA, 13.6%). A significant gender difference was observed, with males more likely to have calcium oxalate and UA stones, while females were more likely to have calcium phosphate and struvite stones. The prevalence of UA stones significantly increased with age, particularly among those aged 65 and older, where UA stones accounted for nearly one-third of all stones. Notably, the proportion of UA stones increased from 3.2% before 2000 to 13.6% in our study period, reflecting a notable rise in the prevalence of UA stones in Taiwan. Conclusion: The prevalence of UA stones has significantly increased in Taiwan, particularly among older adults. This trend highlights the need for ongoing surveillance and tailored public health strategies to address the rising burden of UA stones.