Prognostic factors effecting on recurrence of urinary stone disease: a multivariate analysis of everyday patient parameters.

INTRODUCTION

Since comprehensive urometabolic analyses are currently more preferred for the patients with recurrent stones and with high risk of stone recurrence, we have tried to determine simple patient data increasing stone recurrence to limit sophisticated analyses to certain cases at least in particularly deprivation districts.

MATERIALS AND METHODS

For the study 173 with first-time or recurrent urinary stone were taken. After stone treatment, various empirical metaphylaxis methods were counselled to the patients. The parameters evaluated were (a) age at onset of the disease, (b) gender, (c) urinary pH and (d) specific gravity, (e) serum calcium and (f) uric acid, (g) stone burden, (h) side, and (i) location, (j) treatment modality and (k) recurrence history. New stone formation or growing of the existing stone was considered as stone recurrence. In statistics, independent samples t, chi-square test, Kaplan-Meier, Log rank and Cox regression tests were used.

RESULTS

The mean age was 35 years. The male to female ratio was 88/85. Recurrence occurred in 49 (28%) cases at a mean of 30 months. Stone burden was significantly larger in patients with recurrent stone. In subjects treated with open surgery and with previous recurrence history, stone recurrence rate was significantly higher. In survival analyses, higher serum calcium level, larger stone burden, renal stones and previous recurrence influenced stone prognosis poorly. However in multivariate analysis, none of them was the most significant independent factor.

CONCLUSIONS

According to our study, detailed urometabolic analyses may be somewhat reserved for the patients with ordinary factors increasing risk of stone recurrence including relatively high serum calcium level, large stone burden, upper urinary stone, history of recurrence and open surgery. As a result, it has been thought that the stone risk evaluation guiding detailed laboratory examination may be partially performed with first-line clinical data under limited conditions.