TY  - EJOU
AU  - Li, Shuang 
AU  - Iremashvili, Viacheslav 
AU  - Vernez, Simone L. 
AU  - Penniston, Kristina L. 
AU  - Jhagroo, R. Allan 
AU  - Best, Sara L. 
AU  - Hedican, Sean P. 
AU  - Nakada, Stephen Y. 

TI  - Effect of stone composition on surgical stone recurrence: single center longitudinal analysis
T2  - Canadian Journal of Urology

PY  - 2021
VL  - 28
IS  - 4
SN  - 1488-5581

AB  - <b>Introduction:</b> The objective of this study is to explore the association between urinary stone composition and surgical recurrence.<br/>
<b>Materials and methods:</b> Patients who underwent kidney stone surgeries (between 2009-2017), were followed for > 1 year, and had ≥ 1 stone composition analyses were included in our analysis. Surgical stone recurrence (repeat surgery) was defined as the second surgery on the same kidney unit. Recurrence-free survival analysis was used.<br/>
<b>Results:</b> A total number of 1051 patients were included (52.7% men, average age 59.1 ± 15.1 years). Over 4.7 ± 2.5 years follow-up, 26.7% of patients required repeat surgery. Patients’ stone compositions were calcium oxalate (66.0%), uric acid (12.2%), struvite (10.0%), brushite (5.7%), apatite (5.1%), and cystine (1.0%). Results suggested that patients with cystine stones had the highest surgical recurrence risk; brushite had the second-highest surgical recurrence risk. Struvite, uric acid, and apatite stones were at higher risk compared with calcium oxalate stones (lowest risk in our cohort). When pre- and postoperative stone size was controlled, patients with a history of uric acid, brushite, and cystine stones were at higher surgical risk. After controlling clinical and demographic factors, only brushite and cystine stones were associated with higher surgical recurrence.<br/>
<b>Conclusions:</b> Patients with cystine stones had the highest surgical recurrence risk; brushite stones had the second-highest surgical recurrence risk. Struvite, uric acid, and apatite stones were at higher risk compared with calcium oxalate stones. When pre- and postoperative stone size, clinical, and demographic factors were controlled, only those with brushite or cystine stones were at significantly higher risk of surgical recurrence.
KW  - kidneystones
KW  -  surgery
KW  -  stonecomposition
KW  -  recurrence

DO  -