Predictors of Symptomatic Kidney Stone Recurrence After the First and Subsequent Episodes

Area of Science:

• Nephrology
• Urology
• Epidemiology

Background:

• Kidney stone recurrence affects a significant portion of the population.
• Predicting recurrence is crucial for effective patient management and prevention strategies.

Purpose of the Study:

• To develop and validate a predictive model for symptomatic kidney stone recurrence in community stone formers.
• To identify key clinical and radiographic factors associated with kidney stone recurrence.

Main Methods:

• A longitudinal cohort study followed 3364 incident kidney stone formers in Olmsted County, Minnesota, from 1984 to 2017.
• Clinical and radiographic data from stone episodes were analyzed to identify predictors of subsequent events.
• A parsimonious prediction model was developed and validated using a C-index corrected for optimism.

Main Results:

• Recurrence rates increased significantly with each subsequent stone episode.
• Independent risk factors for recurrence included younger age, male sex, higher BMI, family history, pregnancy, stone type, and imaging findings.
• The developed model demonstrated good predictive accuracy (C-index corrected for optimism = 0.681).
• The 5-year risk of recurrence varied widely (0.9% to 94%) based on identified risk factors.

Conclusions:

• The revised Recurrence Of Kidney Stone (ROKS) tool effectively predicts symptomatic kidney stone recurrence.
• The tool utilizes readily available clinical characteristics, making it practical for clinical use.
• This prediction tool can aid clinicians in risk stratification and personalized management of kidney stone formers.