Evidence for durable kidney stone prevention over several decades.

Area of Science:

• Nephrology
• Urology
• Preventive Medicine

Background:

• Stone prevention clinics aim to reduce recurrence and related procedures.
• Long-term efficacy of these strategies requires evaluation.

Purpose of the Study:

• To analyze stone recurrence rates, procedures, and urinary risk factors in a long-term stone prevention program.
• To assess the sustained effectiveness of stone prevention strategies over extended periods.

Main Methods:

• Analysis of 2509 patients with follow-up data from a dedicated stone prevention clinic.
• Categorization into five time cohorts (5, 10, 15, 20, >20 years) based on follow-up duration.
• Comparison of stone incidence, procedure rates, and 24-hour urinary stone risk factors across cohorts.

Main Results:

• Declines in stone rates, stone-related procedures, and urinary stone risk indices were observed in all follow-up cohorts.
• No diminishing effect of treatment was found over time for any of the analyzed outcomes.
• Sustained reductions in urine supersaturation, a key factor in stone formation, were documented.

Conclusions:

• Patients adhering to long-term active care experienced significant reductions in stone recurrence and urological procedures.
• Continuous medical stone prevention, for up to three decades, proves effective in maintaining low recurrence and procedure rates.
• While effective, only a small proportion of patients remain in continuous long-term treatment.