DISTINCT METABOLIC AND STONE COMPOSITION PATTERNS IN FIRST EPISODE AND RECURRENT UROLITHIASIS PATIENTS
DOI:
https://doi.org/10.22551/MSJ.2025.04.07Abstract
The objective of this study was to identify clinical, metabolic, and compositional factors associated with stone recurrence, using morpho-spectroscopic stone analysis combined with biochemical and dietary assessment. Materials and methods: We retrospectively analyzed 1,380 patients with urinary lithiasis evaluated at the Michel Daudon Morphological and Spectroscopic Analysis Center, Iași, Romania, between 2018 and 2022. Patients were divided into first-episode (n=842) and recurrent (n=538) groups. Demographic data, metabolic profile, dietary habits, and stone composition were assessed. Multivariable logistic regression was used to identify independent predictors of recurrence. Results: Recurrent patients accounted for 39.1% of the cohort and were significantly older. Calcium oxalate monohydrate and dihydrate stones predominated in first episodes, whereas uric acid, urate-mixed, and struvite calculi were more frequent in recurrent cases. Obesity, hyperuricemia, hypertension, type 2 diabetes, and chronic kidney disease were significantly more prevalent among recurrent stone formers. Dietary assessment showed that low fruit and vegetable intake and high sodium consumption were strongly associated with recurrence. Logistic regression identified hyperuricemia (OR=2.3), obesity (OR=1.9), hypertension (OR=1.5), and chronic kidney disease (OR=1.6) as independent predictors. Conclusions: Stone recurrence is characterized by a distinct clinical and metabolic profile, compositional shifts toward uric acid and struvite calculi, and unfavorable dietary habits. These findings confirm the systemic nature of lithiasis and support the integration of morpho-spectroscopic, metabolic, and nutritional evaluation into standard urological practice.
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