title: Evaluation of biochemical urinary stone composition and its relationship to tap water hardness in Qom province, central Iran.
abstract: OBJECTIVE
  The aim of this study was to evaluate the biochemical stone composition in general population of Qom province, central Iran, and its relationship with high tap water hardness.
  
  
  METHODS
  In a prospective study, from March 2008 to July 2011, biochemical analysis of urinary stones in patients living in Qom province for at least 5 years was performed. Stones were retrieved by spontaneous passage, endoscopic or open surgery, and after extracorporeal shockwave lithotripsy. Demographic findings and the drinking water supply of patients were evaluated and compared with biochemical stone analysis.
  
  
  RESULTS
  Stone analysis was performed in 255 patients. The most dominant composition of urinary stones was calcium oxalate (73%), followed by uric acid (24%), ammonium urate (2%), and cystine (1%). The peak incidence of urinary stone was in patients in their forties. Overall male to female ratio was 4.93:1.
  
  
  CONCLUSIONS
  The dominant stone composition in inhabitants of central Iran, where tap water hardness is high, was calcium oxalate stones. On the basis of this study, biochemical urinary stone composition of Qom does not differ from other regions of Iran with lower water hardness.
authors.affiliation: Department of Urology, Kamkar Hospital, School of Medicine, Qom, Iran.
authors.forename: Mohammad Kazem
authors.initials: MK
authors.lastname: Moslemi
authors.forename: Hossein
authors.initials: H
authors.lastname: Saghafi
authors.forename: Seyed Mohammad Amin
authors.initials: SM
authors.lastname: Joorabchin