Abstract
<title>Abstract</title> <p>Objective To find whether there is a significant difference in renal stone mineralogical composition between the main populations in Iraq and to assess the effect of regional, environmental, and ethnic factors on stone formation. Methods This retrospective, cross-sectional, comparative study was done at a national tertiary referral stone center in Sulaymaniyah, Iraq. Clinical data and stone composition profiles were studied for 170 patients (128 Kurdish and 42 Arab) between July 2025 and May 2026. Stone composition was analyzed using Fourier-transform infrared (FTIR) spectroscopy. Results There was a significant relation between ethnicity and primary stone composition (p = 0.0408). Kurdish patients mostly presented with calcium oxalate monohydrate (53.1%). In contrast, although calcium oxalate still had the highest percentage among the Arab patients, they showed a notably higher frequency of uric acid (26.2%) stones. Also, a considerable difference was noted in secondary mineral components for patients that had mixed stones (p = 0.0320), where uric acid was the most frequent secondary component in Arabs (50%). There was no significant difference found in stone complexity (pure vs. mixed, p = 0.5314) or gender distribution (p = 0.8264). The mean stone diameter was 16.5 mm, in patients that mostly had stones for the first time. Conclusion Ethnicity and regional environment influence stone mineralogy in Iraq. The higher amount of uric acid stones in the Arab population is likely because of the arid climate and dietary habits of central and southern Iraq. These findings show the importance of region-specific preventative actions and adapted management to improve patient outcomes.</p>