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Computerized tomography-derived body composition metrics are associated with 24-h urine lithogenic parameters
Reza Lahiji1, Lorenzo Storino Ramacciotti1, Ernie Morton1
1Department of Urology Emory University School of Medicine Atlanta GA United States.
BJUI Compass
|January 19, 2026
Summary
Body composition influences urine profiles in kidney stone patients. Higher muscle mass is linked to increased urine volume and stone-forming substances, while fat distribution and muscle quality also play roles.
Area of Science:
- Nephrology
- Urology
- Radiology
- Metabolic Disorders
Background:
- The link between body composition and urine composition in kidney stone formation is not well understood.
- Assessing body composition may offer new insights into metabolic risk factors for kidney stones.
Purpose of the Study:
- To investigate the association between body composition metrics derived from computed tomography (CT) scans and 24-hour urine parameters in patients with kidney stones.
Main Methods:
- Retrospective review of 443 kidney stone patients with available 24-hour urine tests and CT scans.
- Calculation of skeletal muscle index (SMI), visceral adipose tissue index (VATI), subcutaneous adipose tissue index (SATI), and skeletal muscle density (SMD) from L3 CT images.
- Statistical analysis using Spearman correlations and multivariable logistic regression to identify associations.
Main Results:
- All body composition metrics showed correlations with urine markers.
- Higher SMI was associated with increased odds of elevated urine volume, hyperoxaluria, hyperuricosuria, and hypernatriuria.
- Higher VATI correlated with reduced urine volume, SATI with elevated sodium excretion, and higher SMD with decreased oxalate and hypocitraturia.
Conclusions:
- CT-derived body composition metrics reveal significant relationships with 24-hour urine profiles in stone-forming patients.
- Muscle mass, fat distribution, and muscle quality are identified as factors influencing lithogenic risk.
- Incorporating body composition assessment into the metabolic evaluation of kidney stone patients is recommended.
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