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Centre for Evidence-
Based Medicine

Renal stones - The risk of recurrence is less than 10% per year

Clinical Bottom Line

In patients who have had lithotripsy for urerteric calculus, the risk of recurrence is modest - less than 10% per year. Patients with multiple stones or pyuria are at higher risk; those without at lower risk.

Citation

Kamihira O, et al Long-term stone recurrence rate after extracorporeal shock wave lithotripsy. J Urol 1996 Oct;156(4):1267-71

Clinical Question

What is the risk of recurrence of ureteric calculus after a single episode in a middle aged male?

Search Terms

(renal OR ureteric) AND (calculus OR stone* OR colic) AND recurrence AND year* - search in PROGNOSIS section of PubMed Clinical Queries (emphasising "sensitivity")

The Study

903 patients who were stone-free after extracorporeal shock wave lithotripsy were followed every 6 months with history of recurrence plus a plain abdominal films and/or excretory urograms. Mean followup was 25 months.

The Evidence

There were 183 stone recurrences in 903 patients - a rate of 20% at an average of 25 months. "Survival curve" estimates showed rates of 6.7% at 1 year; 28% at 3 years and 48% at 5 years.

Appraised By

Paul Glasziou