ArticleBMC urology2025
Study on changes in urinary relative supersaturation and risk of stone recurrence in patients after urolithiasis surgery.
Article in BMC urology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundUrolithiasis has a 50% 5-year recurrence rate. Post-operative changes in urinary relative supersaturation (RSS) may refine recurrence prediction and guide targeted interventions.
methodsProspective cohort of 68 stone-free adults (Jan 2023 - Jan 2024 enrollment). 24-hour urine was collected at 2 weeks, 1, 3, 6, 12 months; RSS patterns were analyzed using multivariate modeling. We used a validated food frequency questionnaire adapted for stone-forming nutrients. PRIMARY OUTCOME: radiologic and symptomatic stone recurrence; secondary: ≥30% RSS reduction ("biochemical response"). Risk scoring system developed using logistic regression probabilities. The study was approved by the institutional ethics committee with written informed consent.
resultsAt 24-month median follow-up (range 18-30), 14/68 experienced recurrence (20.6%). Independent predictors: persistently-high CaOx-RSS (OR 6.84, 95% CI 2.13-21.97), CaP-RSS > 1.5 on ≥ 2 visits (OR 4.38, 1.29-14.85), pH-reactive UA-RSS (OR 3.25, 1.04-10.18), urine volume < 1.5 L (OR 3.12, 1.21-8.03). Model performance: AUC 0.81 (95% CI 0.72-0.90); optimal threshold (p = 0.22) yielded sensitivity 0.74, specificity 0.78, PPV 0.46, NPV 0.92. RSS-guided intervention reduced recurrence versus standard care (11.8% vs. 29.4%, p = 0.027) with 44.5% absolute risk reduction in high-risk patients.
conclusionsSerial RSS patterns combined with clinical variables predict recurrence with good accuracy. RSS-tailored therapy significantly reduces recurrence in high-risk patients, though implementation requires addressing feasibility and cost-effectiveness considerations.
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