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Serum and urine uric acid level may have different predictive value for urinary stone composition: a retrospective cohort study of 718 patients in Chinese population

  • Nephrology - Original Paper
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Abstract

Purpose

We launched a retrospective cohort study to explore the interactions among serum uric acid (UA), urine UA, and stone types.

Methods

Clinical characteristics of urolithiasis patients in Beijing Tsinghua Changgung Hospital from October 2015 to August 2017 were retrospectively collected. Participants were categorized according to the quartiles of SUA and UUA respectively. Logistic regression model was built to identify the relationship between stone composition and UA level. Cubic spline was fitted to explore the correlation between 24-h urine UA and serum UA.

Results

718 hospitalized patients (51.1 ± 14.3 years, male 63.4%) with urinary calculi were included. Higher serum UA is associated with male, alcohol use, multiple serum and urine electrolytes (e.g. potassium, chloride, calcium, phosphorus), and lower estimated glomerular filtration rate. The risk of UA stone and carbonate apatite stone was associated with serum UA while the risk of calcium oxalate (CaOx) stone and ammonium magnesium hexahydrate (AMH) was dependent on urine UA. In the unadjusted model (Model 1), higher risks of UA stones were observed in the third quartile (OR 3.26, 95% CIs 1.63–6.53, P = 0.001) and the fourth quartile (OR 3.55, 95% CIs 1.78–7.08, P < 0.001) of serum UA compared with the first quartile. The risks of carbonate apatite stone were lowered in the third (OR 0.48, 95% CIs 0.31–0.73, P = 0.001) and fourth quartile (OR 0.40, 95% CIs 0.42–0.98, P = 0.042) of serum UA. The risk of CaOx stone was increased in the fourth quartile (OR 2.14, 95% CIs 1.15–3.99, P = 0.017) while the risk of AMH stone was decreased in the third (OR 0.46, 95% CIs 0.22–0.94, P = 0.034) and fourth quartile (OR 0.35, 95% CIs 0.16–0.78, P = 0.009) of urine UA. The elevated risks of UA stones in high levels of serum UA were demonstrated in the adjusted model (Model 2). An M-shaped association was found between serum UA and urine UA in our population.

Conclusions

Serum UA and urine UA might cast different impact on urinary calculus composition. Proper control of the parameters should be considered based on different predisposing factors in individual patients.

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Availability of data and material

The datasets used or analyzed during the current study are available from the corresponding author on reasonable request.

Code availability

The code for the analysis of the current study are available from the corresponding author on reasonable request.

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Acknowledgements

We appreciate the support of colleagues from the Department of Urology for sample collection.

Funding

This study was supported by Beijing Tsinghua Changgung Hospital Fund (Grant no. 12015C1034).

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Authors and Affiliations

  1. Department of Nephrology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, No. 168 Litang Road, Beijing, China

    Wen Wen, Yuehong Li & Qi Chen

  2. Department of Urology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, No. 168 Litang Road, Beijing, 102218, China

    Jianxing Li

Authors
  1. Wen Wen
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  2. Yuehong Li
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Contributions

All authors contributed to the study conception and design. Data collection, project development, and manuscript writing were performed by WW. Project designing, manuscript writing, and editing were performed by YL. QC completed the data analysis. JL undertook project development.

Corresponding author

Correspondence to Yuehong Li.

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Conflict of interest

The authors declare no conflicts of interest.

Ethics statement

This study was approved by the Ethics Committee of Beijing Tsinghua Changgung Hospital according to the declaration of Helsinki with the following reference number: 16106–0110.

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All patients had been informed and signed the consent for participation in the study.

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All patients had been informed and signed the consent for publication of the study.

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Wen, W., Li, Y., Chen, Q. et al. Serum and urine uric acid level may have different predictive value for urinary stone composition: a retrospective cohort study of 718 patients in Chinese population. Int Urol Nephrol 54, 2247–2254 (2022). https://doi.org/10.1007/s11255-022-03121-8

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  • DOI: https://doi.org/10.1007/s11255-022-03121-8

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