DOI: 10.36347/sjams.2015.v03i01.105

Pages: 530-537

Background: Nephrolithiasis is a common urological disorder with high recurrence rates, posing a significant burden on patients and healthcare systems. The characterization of urinary lithogenic risk profiles forms the cornerstone of targeted pharmacological therapy in recurrent stone formers. This retrospective cohort study evaluated the lithogenic urinary parameters and pharmacological treatment outcomes in 120 patients diagnosed with recurrent urinary lithiasis at two major medical institutions in India. Methods: A total of 120 recurrent stone formers were enrolled from Bhaskar Medical College, Hyderabad, Telangana, and DR B. R. Ambedkar Medical College, Bangalore, over the period November 2013 to December 2014. Comprehensive 24-hour urinary biochemical profiles including urinary calcium, oxalate, uric acid, citrate, sodium, pH, and volume were obtained. Patients were stratified by stone composition and assigned pharmacological interventions including thiazide diuretics, allopurinol, potassium citrate, or combined therapy. Outcomes were assessed at 13 months. Results: The study cohort had a mean age of 43.2 ± 12.1 years with a male predominance (65.0%). Calcium oxalate was the most prevalent stone type (48.3%), followed by uric acid (20.0%), calcium phosphate (16.7%), and mixed/other (15.0%). Hypercalciuria was detected in 66.7%, hyperoxaluria in 60.0%, and hypocitraturia in 68.3% of subjects. Following pharmacological intervention, significant reductions were observed in urinary calcium (-30.2%), oxalate (-25.9%), and uric acid (-28.9%), with marked improvement in urinary citrate (+56.9%) and volume (+45.5%). Overall stone recurrence rate at 13 months was 26.7%, with combined therapy achieving the lowest recurrence (8.3%). Conclusion: Urinary metabolic profiling effectively identifies pharmacologically modifiable lithogenic risk factors in recurrent stone formers. Targeted pharmacological interventions, particularly combined therapy, significantly reduce urinary