Urolithiasis Risk Factors and Burden: A Hospital-Based Case-Control Study in Northern State Sudan
This hospital-based case-control study in Northern Sudan identifies family history, specific dietary habits (fish, tea, and soft drinks), physical activity, and comorbidities as independent risk factors for urolithiasis, while highlighting the disease's significant clinical and socioeconomic burden on patients.
Original paper licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). This is an AI-generated explanation of the paper below. It is not written or endorsed by the authors. For technical accuracy, refer to the original paper. Read full disclaimer
Kidney stones, medically known as urolithiasis, are hard deposits that form inside the kidneys or urinary tract. They are a widespread health issue globally, causing severe pain and requiring significant medical resources. While doctors understand that factors like genetics, diet, and how much water a person drinks play a role in their formation, the specific mix of causes can vary greatly depending on where a person lives and what they eat. In many parts of the world, researchers have mapped out these risks, but in Sudan, the picture has remained unclear. Understanding the local drivers of this disease is essential because the solutions that work in one climate or culture might not apply in another, especially in a region with unique dietary habits and environmental conditions.
To fill this gap, researchers conducted a detailed investigation at Dongola Specialized Hospital in Northern Sudan, a major medical center serving the region. Between August 2024 and September 2025, the team compared two groups of adults: 91 patients who had just been diagnosed with kidney stones, confirmed by ultrasound or CT scans, and 182 people of similar age, gender, and location who had no evidence of stones. By interviewing these participants about their lives, diets, and medical histories, the researchers aimed to uncover what specifically puts people in this part of Sudan at risk. They looked at everything from family history and daily physical activity to the types of food and drinks people consumed, while also measuring the heavy toll the disease takes on patients' lives and wallets.
The study revealed that kidney stones in this region are not caused by a single factor but by a combination of family history, specific dietary choices, and lifestyle habits. The most powerful predictor found was family history; people with a relative who had stones were significantly more likely to develop them themselves, suggesting a strong genetic link or shared family environment. Diet played a major role as well. The researchers found that people who drank soft drinks regularly were much more likely to have stones than those who avoided them. Similarly, drinking tea, particularly in moderate amounts of two to five cups a day, was linked to a higher risk compared to drinking very large amounts. Surprisingly, eating fish on a regular basis was also associated with a higher likelihood of developing stones, a finding that contrasts with some other parts of the world where fish is often considered protective.
Physical activity and other health conditions also emerged as key players. The study found that people who were more physically active had higher odds of having stones, but the researchers suggest this is likely because their activity often took place under the hot sun, leading to dehydration rather than the exercise itself being the direct cause. Furthermore, patients with other chronic conditions, such as diabetes or high blood pressure, were more frequently affected. Interestingly, while eating meat daily showed a connection in initial checks, this link disappeared when the researchers accounted for other factors, suggesting that meat consumption alone is not the primary driver in this specific population.
Beyond the causes, the study painted a stark picture of the burden these stones place on individuals and the community. The vast majority of patients reported severe pain, with more than half describing their discomfort as intense. This pain led to frequent trips to the hospital, with many patients making monthly visits or multiple emergency room calls. The disease also took a heavy economic toll; patients missed an average of two weeks of work per year, and the median cost to treat a single episode was 150,000 Sudanese pounds. For most families, this expense caused significant financial hardship, and a large majority of patients did not have health insurance to help cover the costs. Complications were also common, with many patients developing urinary tract infections or kidney damage alongside their stones.
The researchers concluded that preventing kidney stones in Northern Sudan will require a tailored approach that addresses these local realities. They suggest that public health efforts should focus on encouraging people to drink enough water, especially when working in the heat, and reconsidering their intake of soft drinks and concentrated tea. Managing chronic diseases like diabetes and hypertension is also crucial. Because the disease strikes families and causes deep financial strain, the study highlights the need for better healthcare access and support systems. While the findings are specific to this region, they offer a clear roadmap for reducing the suffering and cost of kidney stones in a setting where the rules of the disease are written by the local climate, diet, and way of life.
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