URINARY STONE RECURRENCE, RISK FACTORS AND INDIVIDUALIZED PREVENTION: A NARRATIVE REVIEW
Authors/Creators
- 1. Facultad de Ciencias de la Salud, Universidad del Quindío. Armenia, Colombia
- 2. Facultad de Ciencias de la Salud, Universidad Alexander Von Humboldt. Armenia, Colombia.
- 3. Facultad de Ciencias de la Salud, Universidad del Magdalena. Santa Marta, Colombia
- 4. Facultad de Medicina, Universidad El Bosque. Bogotá, Colombia
- 5. Escuela de Medicina, Fundación Universitaria Juan N. Corpas. Bogotá, Colombia.
Description
Article type: Review article
Introduction: urinary stone disease recurs in up to two of every three patients within five years of the first episode, and treating the index stone does not modify that risk. Research on risk factors and research on preventive strategies have advanced separately, so neither resolves the clinician's decision at follow-up: which measure to prescribe to which patient.
Methods: narrative review based on a structured search of four databases (PubMed, Scopus, Web of Science, and SciELO), without date restriction, in studies published in English, Spanish, and Portuguese. The synthesis focused on prospective cohorts and randomized controlled trials with at least 50 participants (35 studies, 1977-2026).
Results: hydration adherence was protective in all five studies evaluating it (HR 0.32 per additional liter of urine output), the only factor with complete concordance; hypercalciuria and hypocitraturia showed a majority but not unanimous association. Citrate, thiazides, and allopurinol were mostly favorable. Diet tailored to the metabolic profile reduced recurrence to 6%, versus 19% with generic diet, which in one trial was also associated with greater recurrence than hydration advice alone (RR 5.6).
Conclusion: preventive efficacy depends less on which intervention is chosen than on whether it matches the patient's metabolic profile; hydration, the only measure with consistently favourable evidence, is limited by adherence rather than by evidence.
Abstract (Spanish)
Tipo de artículo: Artículo de revisión
Introducción: La litiasis urinaria recurre en hasta dos de cada tres pacientes en los cinco años posteriores al primer episodio, y el tratamiento del cálculo inicial no modifica dicho riesgo. La investigación sobre los factores de riesgo y la centrada en las estrategias preventivas han avanzado por separado; por ello, ninguna de ellas resuelve la duda del clínico durante el seguimiento: qué medida prescribir a cada paciente.
Métodos: Revisión narrativa basada en una búsqueda estructurada en cuatro bases de datos (PubMed, Scopus, Web of Science y SciELO), sin restricción de fecha, que incluyó estudios publicados en inglés, español y portugués. La síntesis se centró en cohortes prospectivas y ensayos controlados aleatorizados con al menos 50 participantes (35 estudios, 1977-2026).
Resultados: La adherencia a una hidratación adecuada resultó ser un factor protector en los cinco estudios que la evaluaron (HR 0,32 por cada litro adicional de diuresis), siendo el único factor con una concordancia total; la hipercalciuria y la hipocitraturia mostraron una asociación mayoritaria, aunque no unánime. El uso de citrato, tiazidas y alopurinol resultó, en su mayoría, favorable. Una dieta adaptada al perfil metabólico redujo la recurrencia al 6 %, frente al 19 % observado con
Una dieta genérica; en uno de los ensayos, esta última se asoció incluso a una mayor tasa de recurrencia que la simple recomendación de aumentar la hidratación (RR 5,6).
Conclusión: La eficacia de la prevención depende menos de la intervención elegida que de su adecuación al perfil metabólico del paciente. La hidratación, la única medida que cuenta con evidencia consistentemente favorable, se ve limitada más por la falta de adherencia que por la propia videncia.
Files
sanum_v10_n4_a12.pdf
Additional details
Additional titles
- Translated title (Spanish)
- RECURRENCIA DE LA LITIASIS URINARIA, FACTORES DE RIESGO Y PREVENCIÓN INDIVIDUALIZADA: UNA REVISIÓN NARRATIVA
Dates
- Collected
-
2026-07-29manuscrito recibido
- Accepted
-
2026-09-02evaluación doble ciego
- Available
-
2026-10-30publicación en numero de la revista
Software
- Repository URL
- https://revistacientificasanum.com/
- Development Status
- Active
References
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