There is limited real-world data on the effectiveness of combined prophylactic measures to prevent recurrent kidney stone formation.
This single-center retrospective study evaluated the effect of combined, patient-tailored prophylaxis on metabolic risk factors, urinary crystallization risk indices, and renal colic and urological intervention rates in a real-life clinical setting.
Four hundred ninety patients with nephrolithiasis (NL) with a median follow-up of 12.8 months were evaluated. After the introduction of prophylaxis, the main metabolic risk factors, namely urinary volume, oxalate, calcium, and citrate excretion improved significantly in patients presenting the specific risk factor at baseline (+ 653 ml/24 h for urinary volume, - 10.9 mg/24 h for oxaluria, - 2.35 mmol/24 h for calciuria, and + 901 μmol/24 h for citraturia; all P < 0.001). Relative urinary calcium oxalate supersaturation and Tiselius risk index improved significantly in the total population (- 1.68 and - 0.33, respectively; both P < 0.001). Renal colic and urological intervention rates improved significantly (from 0.82 to 0.21 /1000 d at risk, P < 0.001 for renal colic rate; and from 0.31 to 0.21 /1000 d at risk, P < 0.001 for urological intervention rate). A score expressing overall control of the 4 main metabolic risk factors was significantly associated with a reduction of renal colic rate during follow-up.
Combined, patient-tailored prophylaxis in kidney stone formers significantly improves metabolic risk factors and urinary crystallization risk indices, resulting in a significant reduction of renal colic and urological intervention rates.
Kidney international reports. 2025 Dec 12*** epublish ***
Els Van de Perre, Florine V Janssens, Dieter De Clerck, Wilfried Cools, Peter Janssens, Mandelina Allamani, Tom Robberechts, Freya Van Hulle, Lissa Pipeleers, Karlien François, Dominique Bazin, Christian Tielemans, Michel Daudon, Emmanuel Letavernier, Karl M Wissing
Department of Nephrology and Arterial Hypertension, Universitair Ziekenhuis Brussel (UZ Brussel), Vrije Universiteit Brussel (VUB), Brussels, Belgium., Core Facility - Support for Quantitative and Qualitative Research, Vrije Universiteit Brussel (VUB), Brussels, Belgium., Institut de Chimie Physique, Unité Mixte de Recherche, Centre National de Recherche Scientifique 8000, Université Paris Saclay, Orsay CEDEX, France., Service d'Explorations fonctionnelles multidisciplinaires, Hôpital Tenon, Assistance Publique Hôpitaux de Paris, Paris, France.
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