Clinical risk factors of recurrent kidney stone disease: a cohort retrospective study in a tertiary referral hospital

  • Widi Atmoko Department of Urology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
  • Febriyani Department of Urology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
  • Ary Indriana Savitri Department of Clinical Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
  • Cuno Uiterwaal Department of Clinical Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
  • Siti Setiati Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
  • Agus Rizal Ardy Hariandy Hamid Department of Urology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
  • Ponco Birowo Department of Urology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
  • Nur Rasyid Department of Urology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
Keywords: kidney calculi, nephrolithiasis, urolithiasis

Abstract

BACKGROUND Nephrolithiasis or kidney stone disease (KSD) is common worldwide. Despite various effective treatment strategies, KSD recurrence remains a problem. This study aimed to investigate the risk factors of KSD recurrence.

METHODS This retrospective cohort study used medical records of all patients who came to the Department of Urology, Cipto Mangunkusumo Hospital, Jakarta, from January 2014 to December 2019, with asymptomatic and symptomatic KSD. Demographic information, clinical data, exposure to risk factors, and recurrent KSD diagnosis were collected. Univariate and multivariate analyses using logistic regression were performed to determine the significant risk factors.

RESULTS We reported 325 patients with a median age of 52 years. More than half of the patients were males and from Java. Staghorn stone dominated the KSD types found in 181 patients (55.7%). After undergoing percutaneous nephrolithotomy, 214 patients (65.8%) became stone-free. However, about 40.6% of them later developed recurrent KSD. The adjusted odds ratio in recurrent KSD were 1.46 (95% confidence interval [CI] 1.33–1.59) for younger age, 1.86 (95% CI 1.61–2.07) for overweight–obese, 2.13 (95% CI 1.89–2.31) for less fluid intake, 1.81 (95% CI 0.97–2.12) for routine tea consumption, 1.24 (95% CI 1.06–1.84) for routine vegetables consumption, 2.27 (95% CI 1.83–2.84) for a family history of KSD, and 2.08 (95% CI 1.77–2.39) for diabetes mellitus (DM).

CONCLUSIONS Most patients with recurrent KSD were younger, overweight/obese, had less fluid intake, a family history of KSD, and DM. Modifying a healthy lifestyle and a balanced diet is important to prevent KSD recurrence.

References

Sorokin I, Mamoulakis C, Miyazawa K, Rodgers A, Talati J, Lotan Y. Epidemiology of stone disease across the world. World J Urol. 2017;35(9):1301-20. https://doi.org/10.1007/s00345-017-2008-6

Edvardsson VO, Indridason OS, Haraldsson G, Kjartansson O, Palsson R. Temporal trends in the incidence of kidney stone disease. Kidney Int. 2013;83(1):146-52. https://doi.org/10.1038/ki.2012.320

Liu Y, Chen Y, Liao B, Luo D, Wang K, Li H, et al. Epidemiology of urolithiasis in Asia. Asian J Urol. 2018;5(4):205-14. https://doi.org/10.1016/j.ajur.2018.08.007

Fan X, Kalim S, Ye W, Zhao S, Ma J, Nigwekar SU, et al. Urinary stone disease and cardiovascular disease risk in a rural Chinese population. Kidney Int Rep. 2017;2(6):1042-9. https://doi.org/10.1016/j.ekir.2017.06.001

Gambaro A, Lombardi G, Caletti C, Ribichini FL, Ferraro PM, Gambaro G. Nephrolithiasis: a red flag for cardiovascular risk. J Clin Med. 2022;11(19):5512. https://doi.org/10.3390/jcm11195512

Aune D, Mahamat-Saleh Y, Norat T, Riboli E. Body fatness, diabetes, physical activity and risk of kidney stones: a systematic review and meta-analysis of cohort studies. Eur J Epidemiol. 2018;33(11):1033-47. https://doi.org/10.1007/s10654-018-0426-4

Alelign T, Petros B. Kidney stone disease: an update on current concepts. Adv Urol. 2018;2018:3068365. https://doi.org/10.1155/2018/3068365

Torricelli FCM, Monga M. Staghorn renal stones: what the urologist needs to know. Int Braz J Urol. 2020;46(6):927-33. https://doi.org/10.1590/s1677-5538.ibju.2020.99.07

Sorokin I, Pearle MS. Medical therapy for nephrolithiasis: state of the art. Asian J Urol. 2018;5(4):243-55. https://doi.org/10.1016/j.ajur.2018.08.005

Zisman AL. Effectiveness of treatment modalities on kidney stone recurrence. Clin J Am Soc Nephrol. 2017;12(10):1699-708. https://doi.org/10.2215/CJN.11201016

Taguchi K, Cho SY, Ng AC, Usawachintachit M, Tan YK, Deng YL, et al. The Urological Association of Asia clinical guideline for urinary stone disease. Int J Urol. 2019;26(7):688-709. https://doi.org/10.1111/iju.13957

Tae BS, Balpukov U, Cho SY, Jeong CW. Eleven-year cumulative incidence and estimated lifetime prevalence of urolithiasis in Korea: a national health insurance service-national sample cohort based study. J Korean Med Sci. 2018;33(2):e13. https://doi.org/10.3346/jkms.2018.33.e13

D'Costa MR, Pais VM, Rule AD. Leave no stone unturned: defining recurrence in kidney stone formers. Curr Opin Nephrol Hypertens. 2019;28(2):148-53. https://doi.org/10.1097/MNH.0000000000000478

Rule AD, Lieske JC, Li X, Melton LJ 3rd, Krambeck AE, Bergstralh EJ. The ROKS nomogram for predicting a second symptomatic stone episode. J Am Soc Nephrol. 2014;25(12):2878-86. https://doi.org/10.1681/ASN.2013091011

Zhuo D, Li M, Cheng L, Zhang J, Huang H, Yao Y. A study of diet and lifestyle and the risk of urolithiasis in 1,519 patients in Southern China. Med Sci Monit. 2019;25:4217-24. https://doi.org/10.12659/MSM.916703

Zeng J, Wang S, Zhong L, Huang Z, Zeng Y, Zheng D, et al. A retrospective study of kidney stone recurrence in adults. J Clin Med Res. 2019;11(3):208-12. https://doi.org/10.14740/jocmr3753

Deutsch PG, Subramonian K. Conservative management of staghorn calculi: a single-centre experience. BJU Int. 2016;118(3):444-50. https://doi.org/10.1111/bju.13393

Kohjimoto Y, Sasaki Y, Iguchi M, Matsumura N, Inagaki T, Hara I. Association of metabolic syndrome traits and severity of kidney stones: results from a nationwide survey on urolithiasis in Japan. Am J Kidney Dis. 2013;61(6):923-9. https://doi.org/10.1053/j.ajkd.2012.12.028

Indrahadi D, Wardana A, Pierewan AC. The prevalence of diabetes mellitus and relationship with socioeconomic status in the Indonesian population. J Gizi Klinik Indones. 2021;17(3):103-12. https://doi.org/10.22146/ijcn.55003

Wang W, Fan J, Huang G, Li J, Zhu X, Tian Y, et al. Prevalence of kidney stones in mainland China: a systematic review. Sci Rep. 2017;7:41630. https://doi.org/10.1038/srep41630

Moyano MF, Wendel GH, del Carmen Trujillo L, Orellano GO, Fuentes LB. Weight gain as a potential risk factor in kidney stones formers. Int Res J Nat Sci. 2015;3(4):54-65.

Siener R. Nutrition and kidney stone disease. Nutrients. 2021;13(6):1917. https://doi.org/10.3390/nu13061917

Siener R, Hesse A. Effect of black tea consumption on urinary risk factors for kidney stone formation. Nutrients. 2021;13(12):4434. https://doi.org/10.3390/nu13124434

Daudon M, Jungers P, Bazin D, Williams JC Jr. Recurrence rates of urinary calculi according to stone composition and morphology. Urolithiasis. 2018;46(5):459-70. https://doi.org/10.1007/s00240-018-1043-0

Published
2024-02-02
How to Cite
1.
Atmoko W, Febriyani, Savitri AI, Uiterwaal C, Setiati S, Hamid ARAH, Birowo P, Rasyid N. Clinical risk factors of recurrent kidney stone disease: a cohort retrospective study in a tertiary referral hospital. Med J Indones [Internet]. 2024Feb.2 [cited 2024Feb.21];1(1). Available from: https://mji.ui.ac.id/journal/index.php/mji/article/view/7166
Section
Clinical Research