To explore the changes in the composition of recurrent urinary tract stones and their influencing factors.

A retrospective analysis was conducted on the clinical data of 115 patients with recurrent urinary tract stones who visited Friendship Hospital in Urumqi from January 2011 to January 2022. Patients with recurrent stones were divided into groups based on whether their stone composition had changed (group with changed composition and group without changed composition). The mutual transformation of stone components in each patient after stone recurrence was calculated.Univariate analysis was used to preliminarily screen for potential risk factors that may affect the change of stone components, then multiple logistic regression analysis was conducted.

Among the 115 patients, 36 experienced compositional changes during stone recurrence, with a total change rate of 31.3%. Among the changes in the composition of various stones, the most prominent was the mutual transformation between calcium oxalate stones and infectious stones, followed by the mutual transformation between calcium oxalate stones and uric acid stones. The results of univariate analysis showed that the age of onset of the first stone ≤40 years old, hyperoxaluria, hyperlipidemia, hypocitruria, and the type of initial stone were the factors that affected the changes in the composition of recurrent stones. After multiple logistic regression analysis, it was found that the age of onset of stones ≤40 years old, the type of stones, and hypocitruria were independent risk factors affecting the changes in the composition of recurrent stones, while hyperlipidemia and hyperoxaluria were protective factors.

About one-third of patients with recurrent urinary tract stones experience changes in the composition of the stones, and the mutual transformation between calcium oxalate stones, infectious stones, and uric acid stones is the most common. Patients with early onset of stones are more likely to experience changes in the composition of stones when combined with hypocitriuria, while those with hyperlipidemia and hyperoxaluria have less changes in the composition of stones when they recur. In clinic, attention should be paid to the metabolic assessment of patients with stones, and comprehensive metabolic assessments should be conducted regularly for high-risk patients and appropriate stone prevention plans should be adjusted.