New test predicts individual's risk of a second kidney stone

A new tool that takes multiple factors into account can accurately predict how likely a patient who experienced a painful kidney stone will develop another one in the future. The tool, which is described in an upcoming issue of the Journal of the American Society of Nephrology (JASN), could help patients and their doctors determine whether preventive measures are needed.

Kidney stones are common and affect approximately 6% to 9% of the population. The greatest concern of who have experienced a kidney stone is whether this excruciating painful event will ever happen again. Certain dietary recommendations and medications can help prevent another kidney stone from forming, but these can be burdensome, expensive, or cause side effects. "If we knew which patients were at high risk for another symptomatic kidney stone, then we could better advise patients on whether to follow stone prevention diets or take medications," said Andrew Rule, MD (Mayo Clinic). "At the same time, patients who are at low risk of having another kidney stone may not need restrictive diets and medications."

Dr. Rule and his colleagues conducted a study to help them develop a prediction tool that could be used by patients and their to determine the risk of having a second symptomatic kidney stone after the first. The team reviewed the medical records of all adult first-time symptomatic stone formers residing in Olmsted County, Minnesota, from 1984 to 2003. Of the 2239 individuals identified, 707 experienced a recurrence through 2012.

From the information they gathered, the researchers developed the Recurrence of Kidney Stone (ROKS) nomogram that uses 11 questions about the patient to accurately calculate the probability of having another symptomatic kidney stone at 2, 5, or 10 years after the first stone. Characteristics that predict a higher risk include younger age, male gender, white race, family history of kidney stones, blood seen in the urine, stone made of uric acid (rather than calcium), obstructing stone in the kidney pelvis, any additional non-obstructing stone, and any past painful event attributed to a even though a stone was not seen.

In an accompanying editorial, Brian Eisner, MD (Massachusetts General Hospital and Harvard Medical School) and David Goldfarb, MD (York Harbor VA Healthcare System and NYU School of Medicine) noted that for the nomogram to demonstrate value, it now should be tested prospectively in additional populations of stone formers. "Whether additional variables can be added to increase the usefulness of this tool will be of interest in the ," they added.

More information: The article, entitled "The ROKS Nomogram for Predicting a Second Symptomatic Stone Episode," will appear online at jasn.asnjournals.org/ on August 7, 2014.

The editorial, entitled, "A Nomogram for the Prediction of Kidney Stone Recurrence," will appear online at jasn.asnjournals.org/ on August, 7, 2014.

add to favorites email to friend print save as pdf

Related Stories

Recommended for you

Can robots help stop the Ebola outbreak?

26 minutes ago

The US military has enlisted a new germ-killing weapon in the fight against Ebola—a four-wheeled robot that can disinfect a room in minutes with pulses of ultraviolet light.

New bird flu case in Germany

27 minutes ago

A worrying new strain of bird flu has been observed for the first time in a wild bird in northern Germany, the agriculture ministry said Saturday.

Mali announces new Ebola case

23 hours ago

Mali announced Saturday a new case of Ebola in a man who is fighting for his life in an intensive care unit in the capital Bamako.

Plague outbreak kills 40 in Madagascar: WHO

Nov 22, 2014

An outbreak of plague has killed 40 people in Madagascar, the World Health Organization said, warning that the disease could spread rapidly in the country's densely populated capital Antananarivo.

User comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.