The Prevalence of a Clinically Silent Nephrolithiasis in Baghdad Population: An Initial Ultrasound Screening Study From Iraq

  • Nadhum L. Tahir Department of Family Medicine, Al-Rusafa Health Director, Baghdad, Iraq.
  • Qays A. Hassan Department of Surgery, Al-kindy College of Medicine, University of Baghdad, Baghdad, Iraq.
  • Harth M. Kamber Department of Surgery, Al-kindy College of Medicine, University of Baghdad, Baghdad, Iraq.
Keywords: Silent stones, Kidney, Prevalence, Screening


Asymptomatic or clinically silent kidney stones are possibly serious because, in their expected passage, they may cause infection, obstruction and renal impairment. The purpose of this study was to determine the prevalence of silent kidney stones in a sample of Baghdad population and consider how this value could affect the justification for a screening system. To our best knowledge, this is the first study of its kind conducted in Iraq. We investigated 714 consecutive patients who sustained an abdominal ultrasound at our hospital with further kidney screening. All these patients did not have clinical signs and symptoms of nephrolithiasis. Age, sex, the indication for ultrasound, the size, side, and the number of the discovered stones were recorded. We observed silent kidney stones in 3.4% of patients. Males were stone carriers mostly. Stones were detected more in the left kidney than the right. Distinctly, multiple stones and stones of a large size were minimally seen. We conclude that the prevalence of clinically silent nephrolithiasis of 3.4% does not support a global screening. Yet, this screening may be justified in a limited pattern for those male subjects higher than 50 years, having a positive family history of renal stones, and their socioeconomic status is granted.


1. Dawonauth L, Rademacher L, L’Omelette AD, Jankee S, Yan MY, Jeeawoody RB, et al. Urinary inositol phosphoglycan-P type: near patient test to detect preeclampsia prior to clinical onset of the disease. A study on 416 pregnant Mauritian women. J Reprod Immunol 2014;101:148-52.
2. Diaz SO, Pinto J, Graça G, Duarte IF, Barros AS, Galhano E, et al. Metabolic biomarkers of prenatal disorders: an exploratory NMR metabonomics study of second trimester maternal urine and blood plasma. J Proteome Res 2011;10:3732-42.
3. Newman J. To Siri, With Love: A mother, her autistic son, and the kindness of a machine. Hachette UK, 2017.
4. Stoeckel LE, Arvanitakis Z, Gandy S, Small D, Kahn CR, Pascual-Leone A, et al. Complex mechanisms linking neurocognitive dysfunction to insulin resistance and other metabolic dysfunction. Version 2. F1000Res.2016.
5. Koski KG, Burns DH, inventors; McGill University, assignee. Method and apparatus for analyzing amniotic fluid. United States patent US 2012;8:165.
6. Perfetti C. Reading ability: Lexical quality to comprehension. Sci Stud Read 2007;11:357-83.
7. Nederveen JP, Joanisse S, Snijders T, Parise G. The influence and delivery of cytokines and their mediating effect on muscle satellite cells. Curr Stem Cell Rep 2017;3:192-201.
8. Kuipers F, Bloks VW, Groen AK. Beyond intestinal soap—bile acids in metabolic control. Nat Rev Endocrinol 2014;10:488.
9. Vij K. Textbook of Forensic Medicine & Toxicology: Principles & Practice-e-book. Elsevier Health Sciences, 2014.
10. Norman RA, Paul SP, eds. The Last Natural Man: Where Have We Been and Where Are We Going? Springer, 2017.
11. Preethi DM, Jayanthi VE. Ocular disease diagnosis based on LBP and gabor filter. Int J Sci Eng Res 2014;5:297-304.
12. DeBrabander J, Shay JW, Wang W, Nijhawan D, Theodoropoulos P, inventors; University of Texas System, assignee. Targeting emopamil binding protein (ebp) with small molecules that induce an abnormal feedback response by lowering endogenous cholesterol biosynthesis. United States Patent Application US 2016;15:667.
13. Epstein EB. The Experience of Recovery from Food Addiction. Michigan: Michigan School of Professional Psychology, 2014.
14. Hackett GI. Sexual health and wellbeing. Diabetes in Old Age, 2017.
15. Wahlqvist ML, Krawetz SA, Rizzo NS, Dominguez‐Bello MG, Szymanski LM, Barkin S, et al. Early‐life influences on obesity: from preconception to adolescence. Ann N Y Acad Sci 2015;1347:1-28.
16. Hofmann T, Elbelt U, Stengel A. Irisin as a muscle-derived hormone stimulating thermogenesis–a critical update. Peptides 2014;54:89-100.
17. Bakker L, Sleddering MA, Schoones JW, Meinders AE, Jazet I. Pathogenesis of type 2 diabetes in South Asians. Eur J Endocrinol 2013;169:R99-114.
18. de la Iglesia R, Lopez‐Legarrea P, Crujeiras AB, Pardo M, Casanueva FF, Zulet MA, Martinez JA. Plasma irisin depletion under energy restriction is associated with improvements in lipid profile in metabolic syndrome patients. Clin Endocrinol 2014;81:306-11.
19. Iiuber O. Complex problem solving as multistage decision making. Complex problem solving: The Eur Perspective 2014;4:151.
20. Galhardo MS. Integrated Analysis of Transcript-Level Regulation of Human Adipogenesis and Cell Type-Selective Disease Association of High Regulatory Load Genes [Dissertation]. Luxembourg: University of Luxembourg, 2015.
21. Karras SN, Koufakis T, Fakhoury H, Kotsa K. Deconvoluting the Biological Roles of vitamin D-Binding Protein During Pregnancy: A Both Clinical and Theoretical Challenge. Front Endocrinol 2018;9:259.
22. Crume TL, Shapiro AL, Brinton JT, Glueck DH, Martinez M, Kohn M, et al. Maternal fuels and metabolic measures during pregnancy and neonatal body composition: the healthy start study. J Clin Endocrinol Metab 2015;100:1672-80.
23. Lam SK. The health of the elderly in Hong Kong. Hong Kong University Press, 1997.
24. Nadeem M, Li J, Wang M, Shah L, Lu S, Wang X, et al. Unraveling Field Crops Sensitivity to Heat Stress: Mechanisms, Approaches, and Future Prospects. Agronomy 2018;8:128.
25. Ebert T, Stepan H, Schrey S, Kralisch S, Hindricks J, Hopf L, et al. Serum levels of irisin in gestational diabetes mellitus during pregnancy and after delivery. Cytokine 2014;65:153-8.
26. Lal M. Women’s psychosomatic health promotion and the biopsychosociocultural nexus. Clinical Psychosomatic Obstetrics and Gynaecology: A Patient-centred Biopsychosocial Practice. Oxford Med Online, 2017.
27. Blei F. Literature watch. Emerging roles of the Angiopoietin-Tie and the ephrin-Eph systems as regulators of cell trafficking. Lymphatic Res Biol 2018;16:397-417.
28. Bhutta ZA, Das JK, Rizvi A, Gaffey MF, Walker N, Horton S, et al. Evidence-based interventions for improvement of maternal and child nutrition: what can be done and at what cost? Lancet 2013;382:452-77.
29. Premalatha M, Tabassum-Abbasi, Abbasi T, Abbasi SA. The generation, impact, and management of e-waste: State of the art. Crit Rev Environ Sci Technol 2014;44:1577-678.
30. Goulding R. Handbook of dental pharmacology and therapeutics. Elsevier, 2013.
31. Mather LE. Stereopharmacological research in anaesthesiology, 2015.
32. Heaney RP. Nutrition and risk for osteoporosis. In: Marcus R, Dempster D, Cauley J, Feldman D, eds. Osteoporosis. 4th ed. Waltham, MA: Aca- demic Press, 2013:645-81.
33. Hu FB, Malik VS. Sugar-sweetened beverages and risk of obesity and type 2 diabetes: epidemiologic evidence. Physiol Behav 2010;100:47-54.
34. Leddy MA, Power ML, Schulkin J. The impact of maternal obesity on maternal and fetal health. Rev Obstet Gynecol 2008;1:170.
35. Agudelo LZ, Femenía T, Orhan F, Porsmyr-Palmertz M, Goiny M, et al. Martinez-Redondo V. Skeletal muscle PGC-1α1 modulates kynurenine metabolism and mediates resilience to stress-induced depression. Cell 2014;159:33-45.
36. Spong CY, Mercer BM, D’Alton M, Kilpatrick S, Blackwell S, Saade G. Timing of indicated late-preterm and early-term birth. Obstet Gynecol 2011;118:323.
37. Mahmoud F, Abul H, Dashti A, Al-Jassar W, Omu A. Trace elements and cell-mediated immunity in gestational and pre-gestational diabetes mellitus at third trimester of pregnancy. Acta Medica Academica 2012;41:175-85.
38. Carolan M, Gill GK, Steele C. Women’s experiences of factors that facilitate or inhibit gestational diabetes self-management. BMC Pregnancy Childbirth 2012;12:99.
39. Buchanan TA, Xiang A, Kjos SL, Watanabe R. What is gestational diabetes? Diabetes Care 2007;30:S105-11.
40. Dubuc‐Messier G, Caro SP, Perrier C, van Oers K, Réale D, Charmantier A. Gene flow does not prevent personality and morphological differentiation between two blue tit populations. J Evol Biol 2018;31:1127-37.
41. Houser CM. Neonatal Topics. InPediatric Development and Neonatology. New York, NY: Springer, 2014:35-141.
42. Pajari J. Correlation of endogenous secretory receptor for advanced glycation end product (esRAGE) with metabolic health related biomarkers of skeletal muscle. (Accessed March 2018, 12, at
43. Rahimi R, Karimi J, Khodadadi I, Tayebinia H, Kheiripour N, Hashemnia M, et al. Silymarin ameliorates expression of urotensin II (U-II) and its receptor (UTR) and attenuates toxic oxidative stress in the heart of rats with type 2 diabetes. Biomed Pharmacother 2018;101:244-50.
44. O’brien MD, Rhoads RP, Sanders SR, Duff GC, Baumgard LH. Metabolic adaptations to heat stress in growing cattle. Domest Anim Endocrinol 2010;38:86-94.
45. Wawrusiewicz-Kurylonek N, Telejko B, Kuzmicki M, Sobota A, Lipinska D, Pliszka J, et al. Increased maternal and cord blood betatrophin in gestational diabetes. PloS One 2015;10:e0131171.
46. Jenkins A, Lengyel I, Rutter GA, Lowe N, Shai I, Tirosh A, et al. Obesity, Diabetes and Zinc: A Workshop Promoting Knowledge and Collaboration Between the UK and Israel, November 28-30, 2016–Israel. J Trace Elem Med Biol. 2018 Sep;49:79-85.
47. Drutel A, Archambeaud F, Caron P. Selenium and the thyroid gland: more good news for clinicians. Clin Endocrinol 2013;78:155-64.
48. Prasad AS. Discovery of Human Zinc Deficiency: Its Impact on Human Health and Disease. Adv Nutr 2013;4:176-90.
49. Laires MJ, Monteiro C. Exercise, magnesium and immune function. Magnes Res 2008;21:92-6.
50. Jain S, Sharma P, Kulshreshtha S, Mohan G, Singh S. The role of calcium, magnesium, and zinc in pre-eclampsia. Biol Trace Elem Res 2010;133:162-70.
How to Cite
Tahir NL, Hassan QA, Kamber HM. The Prevalence of a Clinically Silent Nephrolithiasis in Baghdad Population: An Initial Ultrasound Screening Study From Iraq. Acta Med Iran. 57(1):51-56.