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. 2023 Aug 27;23(1):141.
doi: 10.1186/s12894-023-01310-w.

Serum and 24-hour urinary tests cost-effectiveness in stone formers

Abdolreza Mohammadi  1 , Hiro Farabi  2 , Leila Zareian Baghdadabad  1 , Behzad Narouie  3 , Leonardo Oliveira Reis  4 , Seyed Mohammad Kazem Aghamir  5
Affiliations

Serum and 24-hour urinary tests cost-effectiveness in stone formers

Abdolreza Mohammadi et al. BMC Urol. .

Abstract

Objective: To assess the routine serum and 24-hour urine tests proficiency in diagnosing the baseline metabolic abnormality of kidney stone formers.

Methods: This study analyzes the routine serum and 24-hour urine tests proficiency in diagnosing the baseline metabolic abnormality of kidney stone formers. The sensitivity and specificity, false positive, and negative results of the tests are extracted from diagnostic kits used in the laboratories of the target community. To accurately infer the results, a simulation based on 1000 people was used through 22 standard laboratory tests (Additional File 2), including calcium, oxalate, phosphate, uric acid, sulfate, potassium, sodium, citrate, and magnesium in 24-hour urine; and calcium, creatinine, Vit D, uric acid, and intact parathyroid hormone (PTH) in serum. The incremental cost-effectiveness ratio (ICER) was calculated and compared for each diagnostic test versus other diagnostic tests according to the incremental cost required for correct diagnoses of stone causes.

Results: Urinary uric acid, citrate, and serum potassium constitute the cost-effectiveness boundary curve in this study. This means that other diagnostic tests are not cost-effective compared to these three tests in terms of indexing at least one item of cost and effectiveness. The ICER index for each correct diagnosis with the urinary uric acid test was $ 1.25 per diagnosis, the most cost-effective test compared to serum potassium and urinary citrate.

Conclusion: The simplified blood and 24-hour urine metabolic evaluation, including urinary uric acid, citrate, and serum potassium, constitute the cost-effectiveness boundary curve. The most cost-effective test was urinary uric acid measurement.

Keywords: 24-hour urinary test; Cost-effectiveness; Metabolic evaluation; Recurrent kidney stone; Urolithiasis.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Cost-effectiveness diagrams of kidney stone diagnostic tests
See this image and copyright information in PMC

References

    1. LangJ,NarendrulaA,El-ZawahryA,SindhwaniP,EkwennaO.Global trends in incidence and burden of urolithiasis from 1990 to 2019: an analysis of global burden of disease study data.European Urology Open Science.2022;35:37–46. - PMC - PubMed
    1. LiuY,ChenY,LiaoB,LuoD,WangK,LiH,etal.Epidemiology of urolithiasis in Asia.Asian journal of urology.2018;5(4):205–14. - PMC - PubMed
    1. GouruVR,PogulaVR,VaddiSP,ManneV,ByramR,KadiyalaLS.Metabolic evaluation of children with urolithiasis.Urology annals.2018;10(1):94. - PMC - PubMed
    1. Antonelli JA, Maalouf NM, Pearle MS, Lotan Y. Use of the National Health and Nutrition Examination Survey to calculate the impact of obesity and diabetes on cost and prevalence of urolithiasis in 2030. Eur Urol. 2014;66(4):724–9. doi: 10.1016/j.eururo.2014.06.036. - DOI - PMC - PubMed
    1. GambaroG,CroppiE,BushinskyD,JaegerP,CupistiA,TicinesiA,etal.The risk of chronic kidney disease associated with urolithiasis and its urological treatments: a review.The Journal of urology.2017;198(2):268–73. - PubMed