common health problem and are characterized by a high risk of recurrence. A certain number of kidney stones pass asymptomatically. Data regarding the frequency of asymptomatic spontaneous stone passages are limited. Methods To assess the frequency of asymptomatic spontaneous stone passage and its covariates, we conducted a post hoc analysis of the prospective randomized NOSTONE trial. All asymptomatic spontaneous stone passages were identified by comparing the total number of kidney stones on low-dose noncontrast computed tomography (CT) imaging at the beginning and end of the study, considering symptomatic stone passages and surgical stone removal. The statistical analysis focused on the association of independent variables and the number of asymptomatic spontaneous stone passages using linear regression analyses. Results Of the 416 randomized patients, 383 with both baseline and end-of-study CT were included in this analysis. The median follow-up period was 35 months, the median patient age was 49 years (interquartile range [IQR], 40–55), and 20% of the patients were female. A total of 442 stone events occurred in 209 of 383 (55%) patients: 217 of 442 (49%) were symptomatic spontaneous stone passages, 67 of 442 (15%) were surgically removed stones, and 158 of 442 (36%) were asymptomatic spontaneous stone passages. The median size of asymptomatic stones (2.4 mm; IQR, 1.95–3.4) and the size of symptomatic stones (2.15 mm; IQR, 1.68–2.79) that passed spontaneously were not significantly different (P = 0.37). The number of asymptomatic spontaneous stone passages was significantly associated with a higher number of stones on CT at randomization (P = 0.001). Limitations include the lack of data on stone size at the time of passage and overrepresentation of White men. Conclusions Asymptomatic stone passage was common in patients with recurrent calcium-containing kidney stones. The higher the number of stones at presentation, the more likely it was that a kidney stone would spontaneously pass over time without causing any symptoms. Clinical Trial registry name and registration number: NOSTONE trial and: NCT03057431....

中文翻译：

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成人复发性肾结石无症状肾结石排出的危险因素


常见的健康问题，其特点是复发风险高。一定数量的肾结石会无症状地排出。有关无症状自发结石排出频率的数据有限。方法 为了评估无症状自发结石排出的频率及其协变量，我们对前瞻性随机 NOSTONE 试验进行了事后分析。通过比较研究开始和结束时低剂量非对比计算机断层扫描 (CT) 成像的肾结石总数，并考虑有症状的结石排出和手术取石，来识别所有无症状的自发结石排出。统计分析的重点是使用线性回归分析自变量与无症状自发结石通道数量的关联。结果 在 416 名随机患者中，383 名患者均进行了基线和研究结束 CT 检查，均纳入本次分析。中位随访期为 35 个月，中位患者年龄为 49 岁（四分位距 [IQR]，40-55），20% 的患者为女性。 383 名患者中的 209 名 (55%) 患者总共发生了 442 起结石事件：442 名患者中的 217 名 (49%) 是有症状的自发结石通道，442 名患者中的 67 名 (15%) 是手术切除结石，442 名患者中的 158 名 (36%)是无症状的自发性结石通道。无症状结石的中位尺寸（2.4 毫米；IQR，1.95-3.4）和自发排出的有症状结石的尺寸（2.15 毫米；IQR，1.68-2.79）没有显着差异（P = 0.37）。无症状自发结石排出的数量与随机分组时 CT 上结石数量较高显着相关（P = 0.001）。局限性包括缺乏有关当时石头大小的数据以及白人比例过高。 结论 无症状结石排出在复发性含钙肾结石患者中较为常见。就诊时的结石数量越多，肾结石随着时间的推移自然排出而不引起任何症状的可能性就越大。临床试验注册名称和注册号：NOSTONE 试验和：NCT03057431....