Confounding risk factors and preventative measures driving nephrolithiasis global makeup

Table 1 Summary of confounding risk factors (diet intake, obesity, and environment) for each country

Country	Diet[15]	Obesity[16]	Climate
United State	High in sugar and meat	Highly obese (30%-40%)	Varies, Southern states tend to have on average warmer temperatures than the north; though the eastern states tend to have more tropic conditions[17]
Scotland	High in sugar and meat	Highly obese (27.7%)	Temperate[18]
British Isles	High in sugar and meat	Highly obese (14%-27.7%)	Mild winter, warm summers
Australia	High in sugar, meat, and dairy	Highly obese (20%-30%)	Warmer climates
Malayan Peninsula	High in meat and fish	Moderate obesity (16.3%)	Equatorial climate
Spain	Moderate in sugar High in meat	Moderate obesity (15.6%)	Mediterranean climate[19]
Germany	Very high in sugar	Moderate obesity (12.9%)	Temperate
Sweden	High in sugar Moderate in meat	Moderate obesity (12%)	Very mild climate[20]
Italy	High in caffeine	Moderate obesity (9.8%)	Mediterranean climate
Pakistan	High in meat	Low obesity (3.4%)	Weather is extreme depending on the season
Japan	High in fish	Low obesity (3.1%)	Warm and humid
China	High in fish	Low obesity (2.9%)	Temperate, facing lead epidemic
India	High in meat and fish	Low obesity (0.7%)	Hot, tropical climate

Table 2 Prescription medications and treatment of condition with contributions to nephrolithiasis

Medication	Treatment of condition	Function
Acetazolamide	Glaucoma	Diuretic used to prevent and reduce the symptoms of altitude sickness
Vitamin D supplements	Osteoporosis	Mineralization in bone and calcium reabsorption
Vitamin K	Excessive bleeding	Assists blood clots, bones, heart disease
Calcium supplements	Osteoporosis	Assists calcium building, bones, cardiovascular
Warfarin	Blood clotting	Reduce blood pressure/vitamin K inhibitor
Lithium chloride	Mental illness	Psychiatric medication