{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T05:04:25Z","timestamp":1789967065764,"version":"4.0.1"},"reference-count":13,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:00:00Z","timestamp":1789948800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>\n                      To investigate the clinical characteristics and potential risk factors for\n                      <jats:italic>de novo<\/jats:italic>\n                      urolithiasis in recipients after kidney transplantation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We retrospectively screened a source cohort of 2,301 kidney transplant recipients undergoing longitudinal follow-up between January 2015 and December 2025. Forty recipients who developed\n                      <jats:italic>de novo<\/jats:italic>\n                      post-transplant urolithiasis were identified. For each recipient who developed a stone, the date of first stone diagnosis was defined as the index date. Controls who had undergone transplantation and remained under follow-up without detected stones at the corresponding index date were selected using chronological risk-set matching at a maximum 1:2 ratio. Thirty-seven cases were matched to 74 controls. Laboratory exposures were summarized using available baseline\/pre-index measurements. Covariate balance was assessed using standardized mean differences (SMDs). The primary analysis used conditional logistic regression, with Firth bias-reduced conditional logistic regression as a sensitivity analysis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 2,301 recipients, 40 developed\n                      <jats:italic>de novo<\/jats:italic>\n                      post-transplant urolithiasis, corresponding to an observed cumulative proportion of 1.74%. The median time from transplantation to first stone diagnosis was 341.5 days (interquartile range, 41.0\u20131,931.5 days). After risk-set matching, excellent covariate balance was achieved across all matched variables (maximum absolute SMD\u2009=\u20090.037). Standard conditional logistic regression revealed that higher baseline serum urate was significantly associated with an increased risk of\n                      <jats:italic>de novo<\/jats:italic>\n                      urolithiasis [odds ratio (OR) 1.72 per 50\u2005\u03bcmol\/L increase, 95% CI 1.17\u20132.54; P\u2009=\u20090.006], whereas higher serum phosphate exhibited an inverse association (OR 0.77 per 0.1\u2005mmol\/L increase, 95% CI 0.62\u20130.95;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.016). Firth sensitivity analysis confirmed these findings for serum urate (OR 1.64, 95% CI 1.13\u20132.38;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.009) and serum phosphate (OR 0.79, 95% CI 0.65\u20130.97;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.025). Urinary white blood cell (WBC) count showed a strong exploratory association (OR 2.71 per log2 doubling, 95% CI 1.59\u20134.63;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001), though the model exhibited near-separation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Elevated serum urate is consistently associated with an increased risk of\n                      <jats:italic>de novo<\/jats:italic>\n                      urolithiasis following kidney transplantation. Lower serum phosphate represents a potential secondary metabolic signal requiring further validation. While urinary leukocyturia strongly correlated with stone status in exploratory models, it should be interpreted cautiously and not regarded as a definitive causal factor or surrogate for culture-confirmed urinary tract infection.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1866555","type":"journal-article","created":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T04:29:12Z","timestamp":1789964952000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Factors associated with de novo urolithiasis after kidney transplantation: a matched case-control study"],"prefix":"10.3389","volume":"13","author":[{"given":"Wenshi","family":"Tian","sequence":"first","affiliation":[{"name":"Shandong Provincial Qianfoshan Hospital, Shandong University","place":["Jinan, China"]},{"name":"Department of Urology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Institute of Nephrology","place":["Jinan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhengyang","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Urology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Institute of Nephrology","place":["Jinan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Urology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Institute of Nephrology","place":["Jinan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xulei","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Urology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Institute of Nephrology","place":["Jinan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"He","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Urology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Institute of Nephrology","place":["Jinan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kai","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Urology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Institute of Nephrology","place":["Jinan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dongdong","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Urology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Institute of Nephrology","place":["Jinan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bin","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Urology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Institute of Nephrology","place":["Jinan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiwei","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Urology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Institute of Nephrology","place":["Jinan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xianduo","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Urology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Institute of Nephrology","place":["Jinan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoming","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Urology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Institute of Nephrology","place":["Jinan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunchao","family":"Wang","sequence":"additional","affiliation":[{"name":"Shandong Provincial Qianfoshan Hospital, Shandong University","place":["Jinan, China"]},{"name":"Department of Urology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Institute of Nephrology","place":["Jinan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianning","family":"Wang","sequence":"additional","affiliation":[{"name":"Shandong Provincial Qianfoshan Hospital, Shandong University","place":["Jinan, China"]},{"name":"Department of Urology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Institute of Nephrology","place":["Jinan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,21]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"10301","DOI":"10.3390\/ijms241210301","article-title":"Current status regarding immunosuppressive treatment in patients after renal transplantation","volume":"24","author":"Szumilas","year":"2023","journal-title":"Int J Mol Sci"},{"key":"B2","doi-asserted-by":"publisher","first-page":"548","DOI":"10.1097\/MOU.0000000000000618","article-title":"Donor and post-transplant ureteroscopy for stone disease in patients with renal transplant: evidence from a systematic review","volume":"29","author":"Reeves","year":"2019","journal-title":"Curr Opin 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