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• The Maya region holds the highest prevalence of kidney stone in Mexico • The Maya region have the highest frequency of hypocitraturia, hypercalciuria, hypomagnesuria, was 91.3, 68.5 and 42.1%, respectively. • Diet does not appear to be responsible for kidney stone in the Maya region Urinary Stone Disease (USD) arises from an interaction of genetic and environmental factors. Urinary metabolic abnormalities are well described as risk factors. In Mexico, the Maya region holds the highest prevalence of USD. Treatment of these abnormalities lowers the risk of recurrences. Assess the underlying metabolic abnormalities of patients with USD to provide a rationale to lead further prevention strategies. Clinical and demographical data from patients coming to the Stone Clinic were prospectively collected along with a 24 h urinary panel to identify metabolic abnormalities. All participants signed consent and the study was approved by the hospital's institutional review board. A total of 126 patients were included, with a mean age of 47.2 ± 13 years, 75.4% were female. A positive family history of stones was observed in 40 and 87.3% were overweight/obese. The frequency of hypocitraturia, hypercalciuria, hypomagnesuria, hyperoxaluria, and hyperuricosuria was 91.3, 68.5, 42.1, 36.5, and 26.6%, respectively. Median urinary citrate was 79.5 (37.5–160) mg/24 h and was inversely correlated to glycemia. Urine Calcium/Creatinine index was correlated with Hounsfield units (HU) (p = 0.01). Oxalate was correlated with HU and stone burden. Interestingly, dietary distribution of macro- and micronutrients were similar between groups. Patients with a single kidney had lower citrate and higher urinary calcium. Interestingly, a shortage of inhibitors such as citrate and magnesium are highly prevalent in patients with USD from the Maya region and seems to be influenced by other metabolic conditions as malnutrition next to the genetic component. [ABSTRACT FROM AUTHOR]

• Urolithiasis in Maya population from Yucatan. • Composition analysis of kidney stones in Mexico. • Rietveld refinement of kidney stones XRD patterns. • FT-IR spectroscopy of renal calculi. • SEM morphological characterization of kidney stones. Urinary lithiasis is a worldwide disease. It is important to analyze kidney stone composition and identify the minerals that compose them as well as etiology of this disease to develop prophylactic measures. The present work consists of the analysis of 56 kidney stone fragments from patients of the Maya population in Yucatan through X-ray diffraction (XRD), infrared spectroscopy (FT-IR), optical microscopy (OM), and scanning electron microscopy (SEM). Semi-quantitative phase analysis to the diffraction patterns were applied to 56 samples and these were compared with the quantitative phase analysis, calculated by the Rietveld refinement method, in 21 kidney stones selected. Results were classified into oxalates (OX), uric acid (UA), phosphates (PH), and mixed compounds (MX). In the semi-quantitative analysis by XRD principal compounds were oxalates (32%) and phosphates (37%). Also, Rietveld refinement revealed main constituents were oxalates (38%) and phosphates (33.3%). The uricite and the mixed group represented 23.8% and 4.9%, respectively. Average crystallite size of the main mineralogical phases was measured, and it was found that whewellite ranges between 62 and 105 nm, weddellite 77–162 nm, hydroxyapatite 8–70 nm, struvite and uric acid varied 48–85 nm and 65–78 nm, respectively. Statistical analysis showed that the phosphate and the oxalate group are prevalent among the Maya population of Yucatan. [Display omitted] [ABSTRACT FROM AUTHOR]