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Establishment of a new predictive model for the recurrence of upper urinary tract stones

  • Urology - Original Paper
  • Published:
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Abstract

Purpose

To construct a nomogram for evaluation of the recurrence risk of upper urinary tract stones in patients.

Methods

We retrospectively reviewed the clinical data of 657 patients with upper urinary tract stones and divided them into stone recurrence group and non-recurrence group. Blood routine, urine routine, biochemical, and urological CT examinations were searched from the electronic medical record, relevant clinical data were collected, including age, BMI, stones number and location, maximum diameter, hyperglycemia, hypertension, and relevant blood and urine parameters. The Wilcoxon rank-sum test, independent sample t test, and Chi-square test were used to preliminarily analyze the data of the two groups, then LASSO and logistic regression analysis were used to find out the significant difference indicators. Finally, R software was used to draw a nomogram to construct the model, and ROC curve was drawn to evaluate the sensitivity and specificity.

Results

The results showed that multiple stones (OR: 1.832, 95% CI 1.240–2.706), bilateral stones (OR: 1.779, 95% CI 1.226–2.582), kidney stones (OR: 3.268, 95% CI 1.638–6.518), and kidney ureteral stones (OR: 3.375, 95% CI 1.649–6.906) were high risk factors. And the stone recurrence risk was positively correlated with creatinine (OR: 1.012, 95% CI 1.006–1.018), urine pH (OR: 1.967, 95% CI 1.343–2.883), Apo B (OR: 4.189, 95% CI 1.985–8.841) and negatively correlated with serum phosphorus (OR: 0.282, 95% CI 0.109–0.728). In addition, the sensitivity and specificity of the prediction model were 73.08% and 61.25%, diagnosis values were greater than any single variable.

Conclusion

The nomogram model can effectively evaluate the recurrence risk of upper urinary stones, especially suitable for stone postoperative patients, to help reduce the possibility of postoperative stone recurrence.

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Data availability

Data are available with permission from the corresponding author.

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Acknowledgements

We were supported by the Natural Science Foundation of Anhui Province (1908085MH246), and the National Natural Science Foundation of China (82070724).

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Author notes

  1. Kaiguo Xia, Yuexian Xu, and Qiao Qi contributed equally to this work.

Authors and Affiliations

  1. Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, Anhui, China

    Kaiguo Xia, Yuexian Xu, Qiao Qi, Qingfeng Huang, Rui Yao, Junzhi Zhang & Zongyao Hao

  2. Institute of Urology, Anhui Medical University, Hefei, 230022, Anhui, China

    Kaiguo Xia, Yuexian Xu, Qiao Qi, Qingfeng Huang, Rui Yao, Junzhi Zhang & Zongyao Hao

  3. Anhui Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, 230022, Anhui, China

    Kaiguo Xia, Yuexian Xu, Qiao Qi, Qingfeng Huang, Rui Yao, Junzhi Zhang & Zongyao Hao

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Contributions

KX and professor Hao were in charge of designing the project, KX and YX were in charge of writing, KX and QQ were in charge of statistical analysis, QH, JZ, and RY were in charge of collecting data. All the authors reviewed the manuscript.

Corresponding author

Correspondence to Zongyao Hao.

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Conflict of interest

The authors declare no competing financial interests.

Ethical approval

This article was a retrospective study, and supported by the Ethics Committee of the First Affiliated Hospital of Anhui Medical University, the ethical batch number was Quick-PJ2022-14-32. Patient consent were not required in accordance with local or national guidelines.

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All authors supported the publication of manuscript.

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Supplementary Information

Below is the link to the electronic supplementary material.

11255_2023_3698_MOESM1_ESM.tif

Supplementary file1 Urea, creatinine (Cr), cystatin C, serum phosphorus (P), apo B, and urine pH expression levels in the stone recurrence and non-recurrence groups. A-E. The expression level of urea, creatinine (Cr), cystatin C, apo B, and urine pH were higher in stone recurrence group than stone non-recurrence group; F. Serum phosphorus (P) levels were lower in stone recurrence group than stone non-recurrence group (TIF 1885 KB)

11255_2023_3698_MOESM2_ESM.tif

Supplementary file2 Nomogram of upper urinary tract stones prediction model including serum creatinine and serum phosphate as mg/dl (TIF 17276 KB)

Supplementary file3 Nomogram of upper urinary tract stones prediction model without Apo B (TIF 1943 KB)

Supplementary file4 ROC curves of upper urinary tract stones prediction model without Apo B (TIF 7090 KB)

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Xia, K., Xu, Y., Qi, Q. et al. Establishment of a new predictive model for the recurrence of upper urinary tract stones. Int Urol Nephrol 55, 2411–2420 (2023). https://doi.org/10.1007/s11255-023-03698-8

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