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Table 2 The pooled relationship between various risk factors and relapse of kidney stone disease

From: Risk factors for kidney stone disease recurrence: a comprehensive meta-analysis

Risk factors No. of studies No. of patients OR (95% CI) P value Model Heterogeneity
I2(%) P
Demographic risk factors
Age 18 28,315 0.980 (0.966–0.995) 0.009# Random 84.7 < 0.001§
BMI 16 22,087 1.045 (1.008–1.083) 0.016* Random 62.4 < 0.001§
Sex 23 41,466 1.046 (0.945–1.157) 0.388 Random 65.8 < 0.001§
Race 3 4,707 1.338 (1.033–1.732) 0.027* Fixed 0.0 0.982
Pregnant or childbirth 2 3,609 0.896 (0.228–3.525) 0.875 Random 96.8 < 0.001§
Gout 3 18,083 1.181 (0.745–1.871) 0.479 Random 79.4 0.008#
Diabetes 5 29,938 1.095 (0.959–1.251) 0.179 Random 56.3 0.058
Hypertension 5 29,938 1.126 (1.076–1.178)  < 0.001§ Fixed 0.0 0.579
Hyperlipidemia 3 13,114 1.020 (0.670–1.553) 0.925 Random 74.4 0.020*
Osteoporosis 2 16,113 1.140 (0.743–1.749) 0.550 Random 52.5 0.147
Urinary tract anomalies 2 178 1.098 (0.274–4.405) 0.895 Random 65.8 0.087
Kidney stone-related risk factors
Family history of kidney stones 12 11,912 1.194 (1.078–1.323) 0.001# Random 46.8 0.037*
Personal history of kidney stones 11 10,784 1.428 (1.230–1.658) < 0.001§ Random 52.1 0.022*
Any gross hematuria with first symptomatic stone 2 2,737 1.068 (0.893–1.276) 0.473 Fixed 0.0 0.324
Suspected kidney stone episodea prior to first confirmed stone episode 3 6,101 1.815 (1.559–2.114) < 0.001§ Fixed 0.0 0.802
Any concurrent asymptomatic (nonobstructing) stone 2 2,737 1.711 (1.464–1.999) < 0.001§ Fixed 2.0 0.312
Uric acid stone 4 4,602 1.957 (1.414–2.707) < 0.001§ Fixed 40.0 0.172
Calcium oxalate monohydrate 2 3,612 0.897 (0.785–1.025) 0.110 Fixed 0.0 0.331
Calcium phosphate stone 2 1,865 1.271 (0.592–2.731) 0.538 Fixed 37.2 0.207
Diameter of largest kidney stone 8 3,771 1.047 (0.995–1.101) 0.076 Random 74.4 < 0.001§
Multiple calculi 4 1,760 1.338 (0.965–1.855) 0.080 Random 80.3 0.002#
Bilateral nephrolithiasis 2 2,218 2.175 (0.860–5.500) 0.101 Random 82.2 0.018*
Pelvic or lower pole kidney stone 3 6,101 1.666 (1.264–2.195) < 0.001§ Random 76.6 0.014*
Ureteral stone 2 1,387 0.888 (0.380–2.075) 0.785 Random 85.7 0.008#
Ureterovesical junction stone 3 6,101 0.845 (0.761–0.937) 0.001# Fixed 0.0 0.439
Treatment method risk factors
Stone prevention medications 9 4,316 0.752 (0.548–1.033) 0.078 Random 76.0 < 0.001§
Potassium citrate 4 2,992 0.732 (0.345–1.554) 0.417 Random 87.7 < 0.001§
Surgery 3 8,23 2.161 (1.557–2.998) < 0.001§ Fixed 0.0 0.457
ESWl 4 1,495 1.756 (0.606–5.086) 0.299 Random 93.9 < 0.001§
24-h urine and serum tests related risk factors
Baseline urine volume 6 1,789 0.934 (0.756–1.154) 0.528 Random 64.0 0.016*
Baseline urine calcium 8 2,552 1.001 (0.997–1.005) 0.531 Random 55.9 0.026*
Baseline low urine citrate 7 2,371 1.000 (0.998–1.002) 0.994 Random 55.6 0.035*
Baseline urine oxalate 7 2,371 0.999 (0.993–1.004) 0.675 Fixed 26.3 0.228
Baseline urine sodium 4 1,719 1.001 (0.999–1.002) 0.325 Fixed 0.0 0.563
Baseline urine uric acid 6 2,232 1.000 (0.999–1.001) 0.992 Random 51.1 0.069
Baseline urine magnesium 3 1,095 1.081 (0.777–1.503) 0.645 Fixed 0.0 0.780
Baseline urine phosphate 2 422 0.978 (0.315–3.038) 0.969 Random 89.4 0.002#
Baselin urine osmolality 2 855 1.257 (0.629–2.515) 0.517 Random 83.3 0.014*
CaOx SS (DG) 2 314 0.808 (0.611–1.068) 0.134 Fixed 0.0 0.972
Serum calcium 2 348 1.033 (0.787–1.356) 0.817 Fixed 0.0 0.790
GFR 3 1,094 1.017 (0.963–1.074) 0.539 Random 92.3 < 0.001§
24 h urine test completion 2 448,909 1.157 (1.128–1.186)  < 0.001§ Fixed 0.0 0.519
  1. BMI, body mass index; OR, odds ratio; CI, confidence intervals; ESWl, extracorporeal shock wave lithotripsy; SS, supersaturation; DG, delta Gibb’s free energy; GFR, glomerular filtration rate
  2. *P < 0.05; #P < 0.01; §P < 0.001