Preventive Pharmacological Therapy and Risk of Recurrent Urinary Stone Disease Article Swipe
Kumaran Arivoli
,
Autumn N. Valicevic
,
Mary Oerline
,
Ryan S. Hsi
,
Sanjeevkumar R. Patel
,
John M. Hollingsworth
,
Vahakn B. Shahinian
·
YOU?
·
· 2024
· Open Access
·
· DOI: https://doi.org/10.2215/cjn.0000000000000428
YOU?
·
· 2024
· Open Access
·
· DOI: https://doi.org/10.2215/cjn.0000000000000428
Background Urinary stone disease is a prevalent condition associated with a high recurrence risk. Preventive pharmacological therapy has been proposed to reduce recurrent stone episodes. However, limited evidence exists regarding its effectiveness, contributing to its underutilization by physicians. This study aimed to evaluate the association between preventive pharmacological therapy (thiazide diuretics, alkali therapy, and uric acid–lowering medications) and clinically significant urinary stone disease recurrence. Methods Using data from the Veterans Health Administration, adults with an index episode of urinary stone disease from 2012 through 2019 and at least one urinary abnormality (hypercalciuria, hypocitraturia, or hyperuricosuria) on 24-hour urine collection were included. The primary outcome was a composite variable representing recurrent stone events that resulted in emergency department visits, hospitalizations, or surgery for urinary stone disease. Cox proportional hazards regression was performed to estimate the association between preventive pharmacological therapy use and recurrent urinary stone disease while adjusting for relevant baseline patient characteristics. Results Among the cohort of patients with urinary abnormalities ( n =5637), treatment with preventive pharmacological therapy was associated with a significant 19% lower risk of recurrent urinary stone disease during the 12–36-month period after the initial urine collection (hazard ratio, 0.81; 95% confidence interval, 0.65 to 1.00; P = 0.0496). However, the effectiveness of preventive pharmacological therapy diminished over longer follow-up periods (12–48 and 12–60 months after the urine collection) and did not reach statistical significance. When examining specific urinary abnormalities, only alkali therapy for hypocitraturia was associated with a significant 26% lower recurrence risk within the 12–36-month timeframe (hazard ratio, 0.74; 95% confidence interval, 0.56 to 0.97; P = 0.03). Conclusions When considering all urinary abnormalities together, this study demonstrates that the use of preventive pharmacological therapy is associated with a lower risk of clinically significant recurrent episodes of urinary stone disease in the 12–36 month timeframe after urine collection, although only the association with the use of alkali therapy for hypocitraturia was significant when individual abnormalities were examined.
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Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.2215/cjn.0000000000000428
- OA Status
- green
- Cited By
- 10
- References
- 23
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4391755899
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
-
https://openalex.org/W4391755899Canonical identifier for this work in OpenAlex
- DOI
-
https://doi.org/10.2215/cjn.0000000000000428Digital Object Identifier
- Title
-
Preventive Pharmacological Therapy and Risk of Recurrent Urinary Stone DiseaseWork title
- Type
-
articleOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2024Year of publication
- Publication date
-
2024-02-12Full publication date if available
- Authors
-
Kumaran Arivoli, Autumn N. Valicevic, Mary Oerline, Ryan S. Hsi, Sanjeevkumar R. Patel, John M. Hollingsworth, Vahakn B. ShahinianList of authors in order
- Landing page
-
https://doi.org/10.2215/cjn.0000000000000428Publisher landing page
- Open access
-
YesWhether a free full text is available
- OA status
-
greenOpen access status per OpenAlex
- OA URL
-
https://www.ncbi.nlm.nih.gov/pmc/articles/11108239Direct OA link when available
- Concepts
-
Medicine, Urinary system, Hazard ratio, Internal medicine, Proportional hazards model, Hypercalciuria, Uric acid, Urine, Cohort study, Confidence intervalTop concepts (fields/topics) attached by OpenAlex
- Cited by
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10Total citation count in OpenAlex
- Citations by year (recent)
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2025: 6, 2024: 4Per-year citation counts (last 5 years)
- References (count)
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23Number of works referenced by this work
- Related works (count)
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10Other works algorithmically related by OpenAlex
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| abstract_inverted_index.significance. | 228 |
| abstract_inverted_index.abnormalities, | 233 |
| abstract_inverted_index.effectiveness, | 31 |
| abstract_inverted_index.hypocitraturia | 238, 315 |
| abstract_inverted_index.Administration, | 71 |
| abstract_inverted_index.acid–lowering | 55 |
| abstract_inverted_index.hypocitraturia, | 92 |
| abstract_inverted_index.pharmacological | 15, 47, 137, 167, 208, 279 |
| abstract_inverted_index.(hypercalciuria, | 91 |
| abstract_inverted_index.characteristics. | 151 |
| abstract_inverted_index.hyperuricosuria) | 94 |
| abstract_inverted_index.underutilization | 35 |
| abstract_inverted_index.hospitalizations, | 118 |
| cited_by_percentile_year.max | 99 |
| cited_by_percentile_year.min | 97 |
| corresponding_author_ids | https://openalex.org/A5082554505 |
| countries_distinct_count | 1 |
| institutions_distinct_count | 7 |
| corresponding_institution_ids | https://openalex.org/I27837315 |
| sustainable_development_goals[0].id | https://metadata.un.org/sdg/3 |
| sustainable_development_goals[0].score | 0.8399999737739563 |
| sustainable_development_goals[0].display_name | Good health and well-being |
| citation_normalized_percentile.value | 0.96203404 |
| citation_normalized_percentile.is_in_top_1_percent | False |
| citation_normalized_percentile.is_in_top_10_percent | True |