Factors That Can Affect the Occurrence Urinary Stones

Urinary tract stones are the biggest health problem in the field of urology with typical symptoms of pain that can lead to complications in the kidneys. The formation of the stones in the urinary tract (kidneys, ureters, and uretra) due to the deposition of substances in abnormal amounts caused by internal and external factors. The purpose of this study was to determine the factors that can influence the occurrence of Urinary Tract Stones. This study uses a literature review. The Literature Review search uses a database with Google Scholar and keywords that are adjusted to the Medical Subject Heading (MeSH). Data analysis used quality analysis methodology with checklists. The results showed the factors that influence the occurrence of urinary tract stones, among others; heredity, age, gender (male), obesity (BMI> 25) and behavior (regulation of fluid intake <1500 ml per day, diet (consumption of high oxalate vegetables), and length of time to sit. Education to the public through health services regarding the factors that can affect the incidence of urinary tract stones needs to be implemented.


INTRODUCTION
The urinary system is an excretory system that plays a very important role in maintaining the homeostatic balance of electrolyte and water concentrations in the body. The urinary system consists of the kidneys, ureters, bladder and urethra (Purnomo, 2011). Kidney is an organ shaped like a bean with weight and size depending on age, gender in males is generally larger than in females, the presence or absence of a kidney on the other side. The function of the kidney itself is to filter and remove waste such as toxins, excess salt, and urea. Kidneys that cannot perform their functions properly can lead to kidney disease. Kidney diseases include kidney failure, chronic kidney failure, polycystic kidney disease, kidney stones and urinary tract stones. Heading (MeSH). The strategy used to find articles is using PICOS Freemework.

Year of Publication
Literature used in the last 10 years Literature that has not been used for more than 10 years

Indonesian English
Beside Indonesian and English Language Based on the results of the Literature Review search through publications using keywords that have been adjusted using MeSH, the researchers found 5 journal articles according to these keywords.

RESEARCH RESULT
The average number of participants is more than two hundred individuals each study discusses the factors that can influence the occurrence of urinary tract stones. The highest study quality is for the factors that influence the occurrence of BSK and the lowest is for the description of knowledge about the occurrence of BSK. Studies according to this systematic review were conducted entirely in Indonesia with five journals (Martha K. Silalahi, 2020;Retno Sulistiyowati, 2013;Sianturi, d. 2017;Akmal, 2013;Sarwono, 2017). Age is one of the factors that play a role in the occurrence of urinary tract stones because the metabolic process has begun to decline. It was proven from 32 respondents, 28 experienced urinary tract stones with a result of 87.5% (Martha K. Silalahi, 2020). It can be seen in the literature journal that the early elderly age group -the elderly are more likely to experience urinary tract stones. Most often found at the age of 30-50 years (Purnomo, 2011). The decrease in metabolic processes in the body due to age can cause weakness in the working system of the urinary tract.

Gender
Gender is one of the factors that play a role in the occurrence of urinary tract stones. It is proven by the results of Martha K. Silalahi's research (2020) of 32 respondents who are taller in male sex experienced urinary tract stones with a result of 29 experiencing urinary tract stones with a result of 90.6%. The recurrence rate in men is three times higher than in women, this is influenced by serum testosterone which will result in an increase in endogenous oxalate production by the liver (Martha K. Silalahi, 2020).

Descendants
JOSAR, Vol. Heredity is one of the factors that play a role in the occurrence of urinary tract stones, the group of respondents with heredity has the opportunity to suffer from urinary tract stones 18 times with an incidence rate of 96% (Martha K. Silalahi, 2020). The results of the journal are supported by (Retno Sulistiyowati, 2013) family history is one of the supporting factors that also causes urinary tract stones with the results of 5 out of 45 male respondents aged over 40 years, length of stay 30 years or more with 62% results. have urinary tract stones.

Obesity
Obesity is one of the factors that play a role in the occurrence of urinary tract stones, with a greater incidence in the BMI> 25 group, obesity is 96.4%. Because obesity is a state of increasing body fat both throughout the body and in certain parts (Martha K. Silalahi, 2020).
According to Sianturi, (2017) that knowledge on the prevention of recurrence of urinary tract stones totaled 50 patients in the category of dietary knowledge level with sufficient results, namely 31 patients with 62% results. Bad habits in controlling diet can affect the body's metabolism so that it increases the size or shape of the body.

1) Fluid Intake Regulation
Regulation of fluid intake is one of the factors that play a role in the occurrence of urinary tract stones, with a greater incidence in the < 1500 ml group, namely 96.4% (Martha K. Silalahi, 2020). In Retno Sulistiyowati's research (2013) men over 40 years of age, length of stay 30 years or more who consumed <2 liters of water 7 of 45 patients experienced urinary tract stones with a result of 46.7%. Supported by the level of knowledge of patients consuming drinking water to prevent recurrence of urinary tract stones with a total of 50 patients, 34 of whom were in the good category, 68% (Sianturi, d. 2017). People who drink less than 2 liters a day are at risk of developing urinary tract stones 2.112 times greater than people who drink enough (Sarwono, 2017). Lack of water intake and high levels of calcium minerals in the water consumed can increase the incidence of urinary tract stones (Purnomo, 2011). In addition, excessive alcohol consumption will trigger an increase in citrate in the urine, while soft drinks (soda drinks) can increase oxalate levels in the urine, causing urinary tract stones (Sja"bani, 2014). Fluid intake JOSAR, Vol. Long sitting is one of the factors that play a role in the occurrence of urinary tract stones.
The incidence of urinary tract stones caused by sitting time >4 hours/day is 93.1%. The results showed that the occurrence of urinary tract stones was caused by habits and conditions of sitting for too long, namely 25 people (Akmal, 2013). The theory states that patients who sit for too long will experience the release of bone calcium into the blood, which will lead to spurring of stone hypercalcemia due to the process of supersaturation of stone-forming materials in the renal tubules which will change the low saturation stable zone into a high saturation zone. Sitting time while working >4 hours/day of 32 patients 29 of them experienced urinary tract stones with 90.6% results in the study (Martha K. Silalahi, 2020). This explains that as often as possible you must mobilize to prevent sitting too long which is one of the factors for the accumulation of

DISCUSSION
Urinary tract stones are still the biggest health problem in the field of urology with typical symptoms of pain that can lead to complications such as kidney failure. Diseases that arise due to the deposition of substances in abnormal amounts can be caused by various factors, both internal and external. Various symptoms and complications that can arise from urinary tract stones make JOSAR, Vol. The rate of recurrence of urinary tract stones is an average of 7% per year or approximately 50% in 10 years (Purnomo, 2011). As an effort to prevent the recurrence of urinary tract stone disease caused by these influencing factors. The community is expected to be able to pay attention to risk factors to know more about preventive measures or avoid the recurrence of urinary tract stones by modifying patterns and lifestyles. Increasing daily water consumption can dilute the urine so that it can prevent stone formation. Consumption of water in one day at least 8 glasses or the equivalent of 2-3 liters. Consume foods that are low in sodium and purines such as fish, vegetables and reduce animal protein (red meat) to reduce oxalate in the urine and the risk of stone formation in the urinary tract. According to Akmal (2013), people whose jobs are sitting and less mobile are more prone to urinary tract stones than people whose jobs are a lot of movement or physical work. Physical activity is highly recommended with balanced fluid intake.
Health workers are also expected to be able to provide health education regarding risk factors that can affect the incidence of urinary tract stones, so that patients and the community have broad knowledge and receive support from their families to avoid risk factors such as age, heredity, gender, obesity, fluid intake, diet. , and long sitting.

SUGGESTION
The results of this literature review are an update of health science information that commonly occurs among the community, especially the urinary system and further researchers can develop and follow up on the latest research so that it is used as a guide in providing education to the community.