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Comparison of metabolic parameters between pure-uric acid and mixed-uric acid kidney stone formers

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Abstract

Purpose

We seek to compare clinical and 24-h urine parameters between pure-uric acid (UA) and UA–CaOx stone formers in our practice and explore how any differences in metabolic profiles could suggest different prevention strategies between the two groups.

Methods

We retrospectively reviewed patients with either pure- or mixed-UA nephrolithiasis from 2020 to 2023 at a tertiary care center. We included patients with a 24-h urine collection and a stone analysis detecting any amount of UA. Patients were organized into two cohorts: (1) those with 100% UA stones and (2) < 100% UA stones. Differences in demographic characteristics were compared between pure-UA and UA–CaOx stone formers. Twenty-four hour urine metabolic parameters as well as metabolic abnormalities were compared between the pure-uric acid and mixed-uric acid groups.

Results

We identified 33 pure-UA patients and 33 mixed-UA patients. Patient demographics were similar between the groups (Table 1). Pure- and mixed-UA patients had a similar incidence of metabolic syndrome, diabetes, history of stones, and stone burden.

Table 1 Demographic and baseline characteristics among pure- and mixed-uric acid stone formers
Full size table

We found the pure-UA cohort to have 24-h lower urine volume (1.53 vs. 1.96 L/day, p = 0.045) and citrate levels (286 vs. 457 mg/day, p = 0.036). UA–CaOx stone formers had higher urinary calcium levels (144 vs. 68 mg/day, p = 0.003), higher urinary oxalate levels (38 vs. 30 mg/day, p = 0.017), and higher median urinary calcium oxalate super-saturation (3.97 vs. 3.06, p = 0.047).

Conclusions

Pure-UA kidney stone formers have different urinary metabolic parameters when compared with UA–CaOx stone formers, thus requiring different and tailored medical management.

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Data availability

All data are available from the authors if requested.

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Authors and Affiliations

  1. Department of Urology, Icahn School of Medicine at Mount Sinai, 424 W. 59th Street, Suite 4F, New York, NY, 10019, USA

    Anna Ricapito, Kavita Gupta, Christopher Connors, Raymond Khargi, Alan J. Yaghoubian, Johnathan A. Khusid, William M. Atallah & Mantu Gupta

  2. Department of Urology and Kidney Transplant, University of Foggia, Foggia, Italy

    Anna Ricapito

  3. Department of Urology, SUNY Downstate Health Sciences University, Brooklyn, NY, USA

    Jacob Zipkin & Samuel Yim

Authors
  1. Anna Ricapito
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  2. Kavita Gupta
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  3. Jacob Zipkin
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  4. Samuel Yim
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  5. Christopher Connors
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  6. Raymond Khargi
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  7. Alan J. Yaghoubian
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  9. William M. Atallah
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  10. Mantu Gupta
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Contributions

AR and KG involved in protocol/project development; AR, SY, and JZ performed data collection or management; CC and RK involved in data analysis; and AR, KG, RK, AY, JK, WA, and MG involved in manuscript writing/editing.

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Correspondence to Anna Ricapito.

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No conflict of interest.

Research involving Human Participants and/or Animals

Our study was approved by IRB (# 14-00879).

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Data were collected by our IRB-approved retrospectively maintained endourology database.

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Ricapito, A., Gupta, K., Zipkin, J. et al. Comparison of metabolic parameters between pure-uric acid and mixed-uric acid kidney stone formers. World J Urol 42, 138 (2024). https://doi.org/10.1007/s00345-024-04829-1

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  • DOI: https://doi.org/10.1007/s00345-024-04829-1

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