ArticleCentral European journal of urology2026
Metabolic abnormalities and recurrence in high-risk urinary stone formers: A prospective cohort study.
Article in Central European journal of urology, 2026. 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
Introduction: High-risk urinary stone formers are advised to undergo comprehensive metabolic assessment and targeted prophylaxis; however, recurrence outcomes under guideline-based prevention programs remain uncertain. Material and methods: We conducted a prospective, single-center observational cohort study including adult high-risk stone formers rendered stone-free after surgical/endourological treatment. All patients underwent standardized blood tests, 24-hour urine evaluation, and stone composition analysis. Patients with at least one metabolic abnormality received risk factor-specific therapy, whereas those without abnormalities received non-specific measures and lifestyle counseling. Recurrence was defined as a newly detected stone ≥3 mm on follow-up imaging. Results: Sixty-four patients were included (mean age 33.47 ±10.32 years; 60.9% male). At least one metabolic abnormality was identified in 42 patients (65.6%); hypocitraturia was the most frequent abnormality (53.1%). Metabolic syndrome was present in 16 patients (25.0%) and was more common among patients with metabolic abnormalities (33.3% vs 9.1%; p = 0.033). Over a mean follow-up of 24.5 months, recurrence occurred in 10 patients (15.6%). Recurrence rates were 16.7% (7/42) in the targeted-therapy group and 13.6% (3/22) in the non-specific group (p = 0.749), corresponding to a relative risk of 1.22 (95% confidence interval 0.35-4.27). Among patients who experienced recurrence (n = 10), the time to recurrence was 11.8 ±5.69 months (median 12.5 months; range 4-19 months). Conclusions: In this high-risk cohort, metabolic abnormalities were common, and metabolic syndrome clustered with metabolic risk factors. Between-group recurrence estimates were imprecise; larger studies with robust adjustment for baseline risk and adherence are needed. The observational, risk-stratified design precludes causal inference regarding the effectiveness of targeted medical metaphylaxis.
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