Presentation Authors: Robert Geraghty, Sarah Prattley*, Paul Cook, Bhaskar Somani, Southampton, United Kingdom
Introduction: There is a proven association of metabolic syndrome(MetS) and kidney stone disease (KSD). However, no one knows the risk of stone recurrence in these patients. We wanted to look at the recurrence rates in patients with MetS and whether there was an increased risk with every additional component of MetS.
Methods: Kidney stone patients who were seen in the stone clinic between 1990-2005 and underwent detailed metabolic screening were included. Baseline data was collected on serum parameters (creatinine, bicarbonate, calcium, phosphate, parathyroid hormone (PTH)), pH and 24-hour urinary parameters (volume, creatinine, calcium, oxalate, uric acid and creatinine clearance). Other data included patient demographics, past medical history including MetS (hypertension, elevated fasting glucose, high BMI, low serum HDL and elevated triglyceride â€“ modified NCEP ATP III). Patients were followed up in clinic and using their electronic record. Statistical analyses: one-way ANOVA and survival analysis using Cox Regression method. Survival analysis is presented as hazard ratios (HR) and a Cox regression curve.
Results: A total of 256 patients with a mean age of 68 (+/-14.7 years) and a male:female ratio of 179:77 underwent 7.2 (+/-6.1) follow-ups over 18 years (+/-5.7 years). None of the biochemical parameters demonstrated significant results, however there was a trend towards lower pH with increasing number of MetS components. Number of patients with different MetS components are shown in table 1. The time to first stone recurrence was significantly shorter (p < 0.001) with each additional baseline MetS component (Fig 1). Each additional component was associated with increased HR, 2 and 4 components were significant (see table 1).
Conclusions: Our long-term follow-up data from a dedicated stone clinic shows that the risk of first time stone recurrence increases with every additional MetS component