Mp45-04 Clinical Stone Risk Factors Predict Stone Recurrence More Accurately Than 24-Hour Urine Analyte Abnormalities

You have accessJournal of UrologyStone Disease: Epidemiology & Evaluation II (MP45)1 May 2024MP45-04 CLINICAL STONE RISK FACTORS PREDICT STONE RECURRENCE MORE ACCURATELY THAN 24-HOUR URINE ANALYTE ABNORMALITIES Wilson Sui, Kevin Chang, Jorge Mena, Heiko Yang, Maria C. Velasquez, Marshall Stoller, and Thomas Chi Wilson SuiWilson Sui , Kevin ChangKevin Chang , Jorge MenaJorge Mena , Heiko YangHeiko Yang , Maria C. VelasquezMaria C. Velasquez , Marshall StollerMarshall Stoller , and Thomas ChiThomas Chi View All Author Informationhttps://doi.org/10.1097/01.JU.0001008764.86460.8e.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Guidelines for metabolic management of nephrolithiasis includes a risk assessment of stone patients risk factors. High risk characteristics include recurrent stone formation, multiple stones, body mass index (BMI) >30 kg/m2, the presence of established lithogenic comorbidities, and family history. The correlation between these risk factors known to predict stone recurrence and 24-hour urine abnormalities has not been previously studied. As such the goal of this study was to identify associations between 24-hour urine abnormalities and clinical risk stratification. METHODS: The Registry for Stones of the Kidney and Ureter (ReSKU) was queried for all patients who underwent 24-hour urine studies. Patients were categorized by the number of clinical risk factors for recurrent stone disease concordant with the AUA guidelines for metabolic management. Stone recurrence was calculated by stone events per person-year. The stone recurrence and 24-hour urinary analyte values were then compared by risk stratification using students' T-tests, chi-square analysis and Poisson regression. RESULTS: 825 prospectively enrolled patients met our inclusion criteria. When categorized by number of clinical risk factors, 8.6% had none while 28.1% had 1 risk factor, 32.6% had 2 risk factors, and 30.7% had three or more risk factors. Stone recurrence rates escalated with increasing risk factors; 0.34, 0.32, 0.55 and 0.68 stone events per person-year respectively (Figure 1A). Despite categorization based on escalating stone risk, mean 24-hour urinary analyte values did not differ amongst the four groups (Figure 1B). Using a poisson regression the number of clinical stone risk factors obtainable by history or physical exam alone was predictive of stone recurrence. Baseline 24-hour urine values did not predict stone recurrence. CONCLUSIONS: Clinical characteristics based on history and physical exam used to identify high risk patients accurately identified those at risk of stone recurrence. Subsequent 24-hour urine testing did not identify a difference in metabolic activity on 24-hour urine testing to explain the increase in stone recurrence between within these risk groups. These data suggest that stone recurrence may be occurring by a process that is not well distinguished by 24-hour urine testing. Download PPT Source of Funding: N/A © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e743 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Wilson Sui More articles by this author Kevin Chang More articles by this author Jorge Mena More articles by this author Heiko Yang More articles by this author Maria C. Velasquez More articles by this author Marshall Stoller More articles by this author Thomas Chi More articles by this author Expand All Advertisement PDF downloadLoading ...