Patients with multiple ureteral stones are more likely than those with a single ureteral stone to have hypocitraturia and to experience stone recurrence, a study found.

Ho Won Kang, MD, of Chungbuk National University in Cheongju, Korea, and colleagues compared 911 patients who had ureteral stones for the first time and 107 age- and sex-matched patients without stones.

The researchers classified the stone patients into 2 groups: those with a single stone (690 patients) and those with 1 or more additional stones in a ureter or kidney (212 patients). They performed a 24-hour urinary metabolic evaluation was performed on all patients.

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Compared with patients who had a single stone, those with multiple stones had a significantly higher incidence of hypocitraturia (32.1% vs. 18.6%), Dr. Kang and colleagues reported in Urology (2014;84:274-278)..

For their recurrence analyses, the researchers included 240 stone patients who were followed up for more than 12 months (median 35 months). Patients with multiple stones had a 2.3 times increased risk of stone recurrence compared with patients who had a single stone.

“Patients with multiple stones, even it is their first stone episode, should undergo metabolic evaluation and possibly also potassium citrate therapy to prevent future stones,” the authors concluded.