Optimizing Screening Performance for the Risk of Hyperoxaluria and Urolithiasis Using the Urinary Oxalate/Creatinine Ratio: A Retrospective Analysis

IF 3.2 3区 医学 Q1 UROLOGY & NEPHROLOGY
Pierre Letourneau , Lara Cabezas , Aurélie De Mul , Nadia Abid , Christelle Machon , Cécile Poussineau , Cécile Acquaviva , Justine Bacchetta , Laurence Derain-Dubourg , Sandrine Lemoine
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Abstract

Background and objective

The risk of chronic kidney disease (CKD) and nephrolithiasis increases with higher levels of oxalate excretion in 24-h urine, warranting monitoring in specific populations, especially after malabsorptive bariatric surgery. However, implementation of systematic 24-h urine collection is challenging, so there is a need for alternative screening methods.

Methods

Using retrospective data from patients evaluated for the risk of urolithiasis, we assessed different thresholds for the urinary oxalate/creatinine (UOx/Creat) ratio to optimize the screening performance for hyperoxaluria diagnosis and urolithiasis risk using lithogenic risk surrogates.

Key findings and limitations

Among 1264 patients referred for urolithiasis, 38% were excluded because urine collection was considered incomplete. The remaining 786 individuals were included in our analysis, of whom 16% exhibited hyperoxaluria. A UOx/Creat screening threshold between 35 and 45 μmol/mmol demonstrated good performance, depending on the clinical weighting for false-negative versus true-positive results and the cost/benefit ratio.

Conclusions and clinical implications

The UOx/Creat ratio is a promising tool in screening for hyperoxaluria-related complications. However, future research is needed to validate its performance and address the limitations identified to confirm its clinical relevance and effectiveness.

Patient summary

Our study shows that a simple test to measure the ratio of oxalate to creatinine in urine can help in identifying people at risk of kidney stones, especially for patients who have had weight-loss surgery. The test showed good screening performance, but more research is needed to confirm our findings.
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来源期刊
European Urology Open Science
European Urology Open Science UROLOGY & NEPHROLOGY-
CiteScore
3.40
自引率
4.00%
发文量
1183
审稿时长
49 days
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