World journal of urology · 2026
Development and validation of a predictive model for calcium oxalate kidney stone recurrence integrating gut microbiome and clinical features.
СтатьяВалидационное исследованиеНазвание и аннотация: Перевод в очереди
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Dang Kai, Yang Yang, Wang Xiangyu, Cui Teng, Zhou Yongan, Liu Jinhua, Xiao Jing
Аннотация
OBJECTIVE: To characterize the gut microbiome and clinical profiles of patients with recurrent calcium oxalate kidney stones, identify risk factors for recurrence, and develop an integrated predictive model.
METHODS: The development and validation of the prediction model followed the reporting standards outlined in the TRIPOD checklist. In this prospective study, patients with a first calcium oxalate stone episode were enrolled and followed for two years. Gut microbiota were profiled using 16 S rDNA sequencing. Independent risk factors were identified by logistic regression, and a nomogram was constructed and validated with receiver operating characteristic curves, calibration plots, and decision curve analysis.
RESULTS: Among 268 patients, 75 (27.99%) developed recurrence. The recurrent group showed significantly lower gut microbial alpha diversity. LEfSe analysis revealed enrichment of Proteobacteria, Enterococcaceae, Limosilactobacillus, and Escherichia-Shigella, with reduced Firmicutes. Family history of stones (OR = 10.684), elevated serum creatinine (OR = 1.025), and increased Escherichia-Shigella relative abundance (OR = 1.063) were independent risk factors. The nomogram achieved an AUC of 0.978 in the training cohort and 0.943 in the validation cohort, with excellent calibration and net clinical benefit.
CONCLUSION: Recurrent calcium oxalate stone patients exhibit gut dysbiosis characterized by reduced diversity and Escherichia-Shigella enrichment. Family history, serum creatinine, and Escherichia-Shigella abundance independently predict recurrence. The nomogram integrating these factors provides a reliable tool for recurrence risk assessment.
METHODS: The development and validation of the prediction model followed the reporting standards outlined in the TRIPOD checklist. In this prospective study, patients with a first calcium oxalate stone episode were enrolled and followed for two years. Gut microbiota were profiled using 16 S rDNA sequencing. Independent risk factors were identified by logistic regression, and a nomogram was constructed and validated with receiver operating characteristic curves, calibration plots, and decision curve analysis.
RESULTS: Among 268 patients, 75 (27.99%) developed recurrence. The recurrent group showed significantly lower gut microbial alpha diversity. LEfSe analysis revealed enrichment of Proteobacteria, Enterococcaceae, Limosilactobacillus, and Escherichia-Shigella, with reduced Firmicutes. Family history of stones (OR = 10.684), elevated serum creatinine (OR = 1.025), and increased Escherichia-Shigella relative abundance (OR = 1.063) were independent risk factors. The nomogram achieved an AUC of 0.978 in the training cohort and 0.943 in the validation cohort, with excellent calibration and net clinical benefit.
CONCLUSION: Recurrent calcium oxalate stone patients exhibit gut dysbiosis characterized by reduced diversity and Escherichia-Shigella enrichment. Family history, serum creatinine, and Escherichia-Shigella abundance independently predict recurrence. The nomogram integrating these factors provides a reliable tool for recurrence risk assessment.