Wu T. et al., 2026: Risk Factors for Upper Urinary Tract Stone Recurrence: A Retrospective Study of 247 Patients.

Wu T, Zhao C, Mao S, Zhang H.
Med Sci Monit. 2026 Apr 3;32:e951175. doi: 10.12659/MSM.951175

Abstract

BACKGROUND Urolithiasis, as a common disease in urology, has high incidence and recurrence rates. Although there are various treatments and most patients can receive minimally invasive treatment such as ureteroscopic lithotripsy, the high recurrence rate still carries a large disease burden. To explore the potential risk factors, we conducted this retrospective study to evaluate laboratory and demographic factors associated with recurrence of upper urinary tract stones within 3 years in 247 patients. MATERIAL AND METHODS We performed a retrospective analysis of 247 patients who underwent surgical treatment for upper urinary tract stones at Shanghai Tenth People's Hospital from June 2019 to December 2021, among whom 133 patients had at least 1 recurrence within 3 years. Basic information, medical history, blood test results, and urine test results were collected to explore the association of the risk factors with recurrence of upper urinary tract stones. Patients were assigned to either the recurrence group or the n-recurrence group. We analyzed the baseline levels of the 2 groups, and multivariate logistic regression was performed to assess potential risk factors. RESULTS Variables with P value less than 0.05 in single-factor analysis were included in the multifactor analysis. In multivariate logistic regression, the results showed that C-reactive protein-albumin-lymphocyte index and serum creatinine level are risk factors of recurrence of upper urinary tract stones (P<0.05). CONCLUSIONS Patients who underwent surgery for upper urinary tract stones for the first time who had a low C-reactive protein albumin lymphocyte (CALLY) index and high serum creatinine level were at higher risk of recurrence at least once within 3 years.

Comment Hans-Göran Tiselius

The authors studied the risk of recurrent stones in 247 patients who were followed every six months up to three years after stone removal. With special focus on the Asian population they studied the relationship between recurrence and retrospective results of blood analyses.

The conclusion was that high serum creatinine and low CALLY index were related to the risk of recurrence. The CALLY index was calculated from CRP-Albumin-lymphocytes. The result was that low CALLY index and high creatinine were associated with increased recurrence risk.

Although the CALLY index reflects inflammatory status, it is important to realize that recurrent stone formation is a complex procedure in which conclusions based on individual blood tests is insufficient.

Albeit the findings are based on individual blood laboratory results there is no information on stone composition and stone microbiology. The CALLY index gives information on the inflammatory process but is probably insufficient for conclusions on stone recurrence risk.

Hans-Göran Tiselius