Objective
To examine differences in 24-hour urine composition between recurrent and first-time
stone-formers.
Methods
A retrospective review of patients evaluated in 2 metabolic stone clinics was performed.
Recurrent stone formation was defined as patients with a history of more than 1 stone
episode and first-time stone-formers were those with a history of a single-stone episode.
Frequencies of urine metabolic abnormalities were noted. Multivariate linear regression
was performed to evaluate the likelihood of abnormalities of 24-hour urine composition.
Results
Three-hundred eleven patients met inclusion criteria: 71 (22.8%) were first-time stone-formers
and 240 (77.1%) were recurrent stone-formers. On univariate analysis, the likelihood
of having a single abnormality of 24-hour urine composition (ie, hypercalciuria, hyperoxaluria,
hyperuricosuria, or hypocitraturia) was similar between the 2 groups (83.1% for first-time
vs 88.8% for recurrent, P = NS). In addition, there were similar rates of hypercalciuria (39.4% vs 43.3%, P = NS), hyperoxaluria (32.4% vs 33.3%, P = NS), hyperuricosuria (29.6% vs 23.3%, P = NS), and hypocitraturia (45.0% vs 45.0%, P = NS). On multivariate logistic regression, there was no difference in detection
of any urine abnormality (ie, hypercalciuria or hyperoxaluria or hypocitraturia or
hyperuricosuria) between first-time (referent) or recurrent stone-formers (OR 1.68,
95% CI .8-3.5, P = .2).
Conclusion
In this study, detection of urine abnormalities was similar in first-time and recurrent
stone-formers. Given the strong patient preference for stone prevention and the high
success of directed therapy in the literature, we believe it is not unreasonable to
offer comprehensive metabolic evaluation to first-time stone-formers who express a
desire to undergo evaluation.
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Article info
Publication history
Published online: August 23, 2012
Accepted:
June 18,
2012
Received:
November 19,
2011
Footnotes
Financial Disclosure: The authors declare that they have no relevant financial interests.
Identification
Copyright
© 2012 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
