ArticleBMC urology2026
Analysis of clinical factors for hyperoxaluria in patients with calcium oxalate stones: a single-center retrospective cross-sectional study.
Article in BMC 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
backgroundHyperoxaluria is associated with calcium oxalate (CaOx) stone disease and is assessed by quantitative urinary oxalate excretion. We aimed to identify routinely available clinical factors associated with concurrent study-defined hyperoxaluria among adults with CaOx stones.
methodsThis single-center retrospective cross-sectional study included 385 adults with infrared-spectroscopy-confirmed CaOx stones who underwent stone surgery and completed at least one valid preoperative 24-hour urine collection 3-10 days before surgery between January 1 and December 1, 2024. Study-defined hyperoxaluria was urinary oxalate excretion ≥ 40 mg/24 h. The primary exploratory model used forward likelihood-ratio selection after univariable screening; a sensitivity model simultaneously included age, sex, body mass index, and the four factors retained by the stepwise model.
resultsHyperoxaluria was present in 132 of 385 patients (34.3%). In the primary stepwise model, hyperlipidemia (odds ratio [OR] 1.591, 95% confidence interval [CI] 1.031-2.457; P = 0.036), a positive urine nitrite test (OR 2.356, 95% CI 1.114-4.986; P = 0.025), diabetes mellitus (OR 1.811, 95% CI 1.055-3.109; P = 0.031), and at least two previous stone operations (OR 1.632, 95% CI 1.048-2.541; P = 0.030) were associated with hyperoxaluria. In the prespecified sensitivity model, all effect directions were unchanged, but hyperlipidemia was not statistically significant (OR 1.499, 95% CI 0.966-2.326; P = 0.071); the other three associations remained statistically significant.
conclusionsIn surgically treated adults with composition-confirmed CaOx stones, the stepwise model identified four concurrent correlates of study-defined hyperoxaluria, whereas sensitivity analysis indicated that the hyperlipidemia association was model-dependent. The associations with a positive urine nitrite test, diabetes mellitus, and at least two previous stone operations were more stable across models. These exploratory indicators may help prioritize confirmatory 24-hour urine testing where access is limited, but they cannot replace metabolic evaluation or establish causality.
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