# Predictors of Recurrent Ureteral Stones: A Retrospective Analysis of Clinical, Demographic, and Metabolic Factors

## TL;DR

This study identifies gout and uric acid stones as key factors linked to recurring ureteral stones in Saudi Arabia.

## Contribution

The study provides region-specific insights into predictors of ureteral stone recurrence in the Middle East.

## Key findings

- Gout was independently associated with a higher risk of ureteral stone recurrence.
- Uric acid stone composition was a significant predictor of recurrence.
- Back pain showed a trend toward significance in predicting recurrence.

## Abstract

Background

While global meta-analyses have identified broad risk factors for kidney stone recurrence, data on specific determinants of recurrent ureteral stones in the Middle Eastern region remain limited. We aimed to identify the clinical, demographic, and metabolic determinants of recurrent ureteral stones, including body mass index (BMI).

Materials

This retrospective cohort study was conducted at a single institution in Saudi Arabia. Clinical data from 57 patients with ureteral stones were analyzed. The variables included age, sex, BMI, stone composition, comorbidities (diabetes mellitus (DM), hypertension (HT), and gout), and back pain. Univariate (independent t-tests and chi-square tests) and multivariate logistic regression models were used to assess associations with recurrence. Recurrence was defined as two or more episodes of stone passage or intervention within 12 months.

Results

Recurrence occurred in 30% of the patients. On multivariate analysis, gout (odds ratio (OR): 8.6, 95% confidence interval (CI): 1.3-56.7, p = 0.026) and uric acid stones (OR: 4.9, 95% CI: 1.1-21.9, p = 0.038) were independently associated with recurrence, while back pain showed a trend toward significance (OR: 4.1, 95% CI: 0.9-18.6, p = 0.07). BMI, age, and sex were not significantly associated (p > 0.05).

Conclusion

Gout and uric acid stone composition were independent predictors of ureteral stone recurrence. Despite the limitations of a small sample size and short follow-up period, targeted metabolic screening and management of hyperuricemia may reduce the risk of recurrence.