{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T18:04:07Z","timestamp":1779818647008,"version":"3.53.1"},"reference-count":36,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T00:00:00Z","timestamp":1779753600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Nephrolithiasis is commonly observed in patients with gout; however, the role of asymptomatic hyperuricemia in stone formation remains unclear. This study evaluated the association between serum uric acid levels and nephrolithiasis in a large health screening population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a cross-sectional analysis of 31,198 Korean adults who underwent health checkups between 2010 and 2020. Clinical parameters included anthropometric measures, blood pressure, serum uric acid, renal and hepatic function markers, lipid profiles, glycemic indices, inflammatory biomarkers, serum calcium, and vitamin D3 levels. Nephrolithiasis was defined as the presence of at least one renal stone \u22655\u2009mm detected by ultrasonography and\/or kidney\u2013ureter\u2013bladder radiography. Hierarchical logistic regression models (unadjusted, age- and BMI-adjusted, and fully adjusted) were used to assess associations separately in men and women.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Median serum uric acid concentrations were 6.0\u2009mg\/dL in men and 4.4\u2009mg\/dL in women. In men, higher serum uric acid levels were associated with nephrolithiasis across hierarchical models. In fully adjusted analyses, serum uric acid remained significantly associated with stone prevalence, and men in the highest uric acid quartile (\u22656.9\u2009mg\/dL) had higher odds compared with those in the lowest quartile (adjusted OR: 3.546; 95% CI: 1.240\u201310.144). No statistically significant association was observed in women.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Higher serum uric acid levels were associated with nephrolithiasis in men but not in women in this cross-sectional analysis. These findings contribute to the epidemiologic understanding of sex-specific differences in stone risk; prospective studies are needed to clarify causality and potential clinical implications.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0349819","type":"journal-article","created":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T17:25:35Z","timestamp":1779816335000},"page":"e0349819","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Association between asymptomatic hyperuricemia and kidney stones"],"prefix":"10.1371","volume":"21","author":[{"given":"Jun Ho","family":"Lee","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzy","family":"Park","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-3777-2770","authenticated-orcid":true,"given":"Nuri","family":"Oh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dae Yeon","family":"Cho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2614-6070","authenticated-orcid":true,"given":"Jae Yoon","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,5,26]]},"reference":[{"issue":"1","key":"pone.0349819.ref001","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1007\/s00240-020-01210-w","article-title":"Trends in the prevalence of kidney stones in the United States from 2007 to 2016","volume":"49","author":"A Chewcharat","year":"2021","journal-title":"Urolithiasis"},{"issue":"4","key":"pone.0349819.ref002","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1001\/jama.293.4.455","article-title":"Obesity, weight gain, and the risk of kidney stones","volume":"293","author":"EN Taylor","year":"2005","journal-title":"JAMA"},{"issue":"4","key":"pone.0349819.ref003","doi-asserted-by":"crossref","first-page":"858","DOI":"10.1016\/j.juro.2017.03.124","article-title":"Dietary and Lifestyle Risk Factors Associated with Incident Kidney Stones in Men and Women","volume":"198","author":"PM Ferraro","year":"2017","journal-title":"J Urol"},{"issue":"1","key":"pone.0349819.ref004","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1093\/ndt\/gfac037","article-title":"Factors associated with sex differences in the risk of kidney stones","volume":"38","author":"PM Ferraro","year":"2023","journal-title":"Nephrol Dial Transplant"},{"issue":"9507","key":"pone.0349819.ref005","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1016\/S0140-6736(06)68071-9","article-title":"Kidney stones: pathophysiology and medical management","volume":"367","author":"OW Moe","year":"2006","journal-title":"Lancet"},{"issue":"1","key":"pone.0349819.ref006","first-page":"17","article-title":"Uric Acid nephrolithiasis: recent progress and future directions","volume":"9","author":"TC Ngo","year":"2007","journal-title":"Rev Urol"},{"key":"pone.0349819.ref007","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1007\/s12018-011-9106-6","article-title":"Uric Acid Nephrolithiasis: A Systemic Metabolic Disorder","volume":"9","author":"MR Wiederkehr","year":"2011","journal-title":"Clin Rev Bone Miner Metab"},{"issue":"5","key":"pone.0349819.ref008","article-title":"Uric acid-induced phenotypic transition of renal tubular cells as a novel mechanism of chronic kidney disease","volume":"304","author":"E-S Ryu","year":"2013","journal-title":"Am J Physiol Renal Physiol"},{"issue":"1","key":"pone.0349819.ref009","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1080\/0886022X.2022.2036620","article-title":"Research progress on related mechanisms of uric acid activating NLRP3 inflammasome in chronic kidney disease","volume":"44","author":"M Wang","year":"2022","journal-title":"Ren Fail"},{"issue":"1","key":"pone.0349819.ref010","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1186\/s13075-015-0610-9","article-title":"Gout and risk of chronic kidney disease and nephrolithiasis: meta-analysis of observational studies","volume":"17","author":"MJ Roughley","year":"2015","journal-title":"Arthritis Res Ther"},{"issue":"3","key":"pone.0349819.ref011","doi-asserted-by":"crossref","first-page":"1022","DOI":"10.1046\/j.1523-1755.2003.t01-2-00171.x","article-title":"The association between gout and nephrolithiasis in men: The Health Professionals\u2019 Follow-Up Study","volume":"64","author":"HJ Kramer","year":"2003","journal-title":"Kidney Int"},{"issue":"5","key":"pone.0349819.ref012","first-page":"653","article-title":"The Occurrence of Nephrolithiasis in Gout Patients: A Longitudinal Follow-Up Study Using a National Health Screening Cohort","volume":"12","author":"SY Kim","year":"2022","journal-title":"Life (Basel)"},{"issue":"5","key":"pone.0349819.ref013","doi-asserted-by":"crossref","first-page":"312","DOI":"10.5114\/reum.2020.100140","article-title":"Pathophysiology of hyperuricemia and its clinical significance - a narrative review","volume":"58","author":"M Skoczy\u0144ska","year":"2020","journal-title":"Reumatologia"},{"issue":"6","key":"pone.0349819.ref014","doi-asserted-by":"crossref","first-page":"928","DOI":"10.1093\/ckj\/sfad006","article-title":"Asymptomatic hyperuricaemia in chronic kidney disease: mechanisms and clinical implications","volume":"16","author":"H-J Anders","year":"2023","journal-title":"Clin Kidney J"},{"issue":"1","key":"pone.0349819.ref015","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1038\/s41392-024-01916-y","article-title":"Hyperuricemia and its related diseases: mechanisms and advances in therapy","volume":"9","author":"L Du","year":"2024","journal-title":"Signal Transduct Target Ther"},{"issue":"1","key":"pone.0349819.ref016","doi-asserted-by":"crossref","first-page":"28357","DOI":"10.1038\/s41598-024-80147-1","article-title":"Analysis of components and related risk factors of urinary stones: a retrospective study of 1055 patients in southern China","volume":"14","author":"Y Wang","year":"2024","journal-title":"Sci Rep"},{"issue":"9","key":"pone.0349819.ref017","doi-asserted-by":"crossref","first-page":"837","DOI":"10.1038\/hr.2017.42","article-title":"Antihypertensive medications and the risk of kidney stones in older adults: a retrospective cohort study","volume":"40","author":"RT Alexander","year":"2017","journal-title":"Hypertens Res"},{"issue":"1","key":"pone.0349819.ref018","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1016\/j.eururo.2013.03.026","article-title":"Diabetic severity and risk of kidney stone disease","volume":"65","author":"AE Weinberg","year":"2014","journal-title":"Eur Urol"},{"issue":"3","key":"pone.0349819.ref019","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1590\/s1677-5538.ibju.2022.0587","article-title":"Impact of body mass index on size and composition of urinary stones: a systematic review and meta-analysis","volume":"49","author":"D Wang","year":"2023","journal-title":"Int Braz J Urol"},{"issue":"1","key":"pone.0349819.ref020","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1007\/s00240-014-0719-3","article-title":"Dyslipidemia is associated with an increased risk of nephrolithiasis","volume":"43","author":"JH Masterson","year":"2015","journal-title":"Urolithiasis"},{"issue":"2","key":"pone.0349819.ref021","doi-asserted-by":"crossref","first-page":"271","DOI":"10.5527\/wjn.v4.i2.271","article-title":"Effect of urinary stone disease and its treatment on renal function","volume":"4","author":"MN Mercimek","year":"2015","journal-title":"World J Nephrol"},{"issue":"1","key":"pone.0349819.ref022","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1186\/s12882-024-03476-3","article-title":"The association between C-reactive protein levels and the risk of kidney stones: a population-based study","volume":"25","author":"D Liang","year":"2024","journal-title":"BMC Nephrol"},{"issue":"28","key":"pone.0349819.ref023","article-title":"The effect of metabolic risk factors on urinary stone composition: An observational study","volume":"101","author":"JY Kim","year":"2022","journal-title":"Medicine (Baltimore)"},{"issue":"2","key":"pone.0349819.ref024","article-title":"Association between calcium and vitamin D supplementation and increased risk of kidney stone formation in patients with osteoporosis in Southwest China: a cross-sectional study","volume":"15","author":"L Shi","year":"2025","journal-title":"BMJ Open"},{"issue":"3","key":"pone.0349819.ref025","first-page":"235","article-title":"Calcium intake and urinary stone disease","volume":"3","author":"MD Sorensen","year":"2014","journal-title":"Transl Androl Urol"},{"issue":"12","key":"pone.0349819.ref026","doi-asserted-by":"crossref","first-page":"1258","DOI":"10.1089\/end.2020.0486","article-title":"Nonalcoholic Fatty Liver Disease Is an Independent Risk Factor for Nephrolithiasis in Women: Findings from NHANES III","volume":"34","author":"RD Decker","year":"2020","journal-title":"J Endourol"},{"issue":"6","key":"pone.0349819.ref027","doi-asserted-by":"crossref","first-page":"534","DOI":"10.1089\/end.2004.18.534","article-title":"Progression of nephrolithiasis: long-term outcomes with observation of asymptomatic calculi","volume":"18","author":"A Burgher","year":"2004","journal-title":"J Endourol"},{"issue":"5","key":"pone.0349819.ref028","doi-asserted-by":"crossref","first-page":"1740","DOI":"10.1016\/j.juro.2012.11.113","article-title":"Natural history of asymptomatic renal stones and prediction of stone related events","volume":"189","author":"HW Kang","year":"2013","journal-title":"J Urol"},{"issue":"2","key":"pone.0349819.ref029","doi-asserted-by":"crossref","first-page":"86","DOI":"10.4103\/JMU.JMU_49_19","article-title":"Is combined ultrasound with radiography sufficient for the diagnosis of obstructive ureteric stone in patients with acute flank pain?","volume":"28","author":"S Wongwaisayawan","year":"2020","journal-title":"J Med Ultrasound"},{"issue":"2","key":"pone.0349819.ref030","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1053\/j.ajkd.2017.01.053","article-title":"Development of Nephrolithiasis in Asymptomatic Hyperuricemia: A Cohort Study","volume":"70","author":"S Kim","year":"2017","journal-title":"Am J Kidney Dis"},{"issue":"1","key":"pone.0349819.ref031","doi-asserted-by":"crossref","first-page":"1525","DOI":"10.1186\/s12889-023-16469-y","article-title":"Asymptomatic hyperuricemia associated with increased risk of nephrolithiasis: a cross-sectional study","volume":"23","author":"H Deng","year":"2023","journal-title":"BMC Public Health"},{"key":"pone.0349819.ref032","doi-asserted-by":"crossref","first-page":"117333","DOI":"10.1016\/j.biopha.2024.117333","article-title":"New insight into oxidative stress and inflammatory responses to kidney stones: Potential therapeutic strategies with natural active ingredients","volume":"179","author":"Y Sun","year":"2024","journal-title":"Biomed Pharmacother"},{"key":"pone.0349819.ref033","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1016\/j.euros.2025.04.003","article-title":"Revisiting Uric Acid Stone Dissolution Kinetics: Insights for Optimizing Medical Therapy","volume":"76","author":"P Lotan","year":"2025","journal-title":"Eur Urol Open Sci"},{"issue":"5","key":"pone.0349819.ref034","article-title":"Menopause, postmenopausal hormone use and serum uric acid levels in US women--the Third National Health and Nutrition Examination Survey","volume":"10","author":"AE Hak","year":"2008","journal-title":"Arthritis Res Ther"},{"issue":"9179","key":"pone.0349819.ref035","doi-asserted-by":"crossref","first-page":"650","DOI":"10.1016\/S0140-6736(99)92381-4","article-title":"Reduction of serum uric acid by hormone replacement therapy in postmenopausal women with hyperuricaemia","volume":"354","author":"H Sumino","year":"1999","journal-title":"Lancet"},{"issue":"2","key":"pone.0349819.ref036","first-page":"114","article-title":"Metabolic syndrome and nephrolithiasis: can we hypotize a common background?","volume":"5","author":"G Mossetti","year":"2008","journal-title":"Clin Cases Miner Bone Metab"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0349819","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T17:25:41Z","timestamp":1779816341000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0349819"}},"subtitle":[],"editor":[{"given":"Yung-Hsiang","family":"Chen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,5,26]]},"references-count":36,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2026,5,26]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0349819","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,26]]}}}