Multivariate Analysis Of Patients With Calcium Oxalate Stones Assessed Based On 24-Hour Urine Composition

【 Background and Objective 】 Urolithiasis is one of the most common diseases of the urinary system.The results of 24-hour urinalysis are the basis for the selection of interventions to prevent stone recurrence.This study was based on a multivariate analysis of 24-hour urine composition to assess the recurrence of calcium oxalate stones in patients.【Patients and Methods】atients diagnosed with calcium oxalate stones after calculus surgery in a minimally invasive center of our hospital from November 2020 to July 2022 were collected and analyzed.Basic demographic data,blood biochemistry,and 24-hour urine samples of patients who underwent urolithiography were collected and analyzed.The 24-hour urinalysis protocol included volume,p H,oxalate,citrate,sodium,potassium,chloride,calcium,phosphorus,creatinine,urate,magnesium,calcium oxalate ion active products(APCa Ox index),and calcium phosphate(APCa P index),and the 24-hour urine composition were compared according to different groups.【Results】Univariate analysis of recurrent calcium oxalate stone patients in the binary Logistics regression equation showed that compared with the recurrent calcium oxalate stone group,BMI,urine p H value,blood urea nitrogen,and citric acid excretion rate were significantly different.According to multivariate analysis,Blood urea nitrogen,BMI and urine p H were included in the binary logistics regression equation and were positively correlated with recurrence.To verify the influencing factors,univariate Cox and multivariate Cox regression equations were conducted for the recurrence of calcium oxalate stone patients.The results showed that the risk factors included urine volume,urine magnesium,urine chlorine,urine potassium,urine calcium,BMI,and age,and the above indexes were selected for multivariate Cox regression analysis.Multivariate Cox regression analysis showed that urinary calcium,urinary volume <2L,age,and high BMI as risk factors were positively correlated with calcium oxalate stone recurrence.Subgroup comparisons were then made based on BMI,season,and sex,and magnesium and citrate were found to be negatively correlated with BMI,and the 24-hour calcium oxalate excretion rate was significantly increased in winter compared with summer calcium oxalate stone participants(P<0.05).There were no significant differences in 24-hour urine volume of other components,p H value,citrate,sodium,potassium,chloride,calcium,phosphorus,creatinine,urate,and magnesium among calcium oxalate stone patients grouped by two seasons and two genders(P>0.05).【 Conclusions 】 In calcium oxalate stone patients,compared with calcium oxalate stone patients in the initial group,the recurrence group was positively correlated with BMI,urine p H,and blood urea nitrogen.In subgroup analysis,it was also confirmed that the excretion rate of citric acid was negatively correlated with BMI.Gender factors and seasonal factors of stone onset were not included in the multivariate analysis of recurrence in patients with calcium oxalate stones.