{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T13:23:57Z","timestamp":1783085037339,"version":"3.54.6"},"reference-count":20,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T00:00:00Z","timestamp":1783036800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Epidemiologia"],"abstract":"<jats:p>Background: Urolithiasis is a common condition characterized by a high risk of recurrence, although this risk varies substantially between patients. The present study aimed to quantify incidence, identify determinants, and model recurrence risk between stone composition and recurrence, and to assess the role of selected clinical and behavioral factors in a cohort of patients with confirmed stone clearance. Methods: This retrospective cohort study included adult patients with urolithiasis managed between 2017 and 2021 in a specialized referral center. Only patients with confirmed stone-free status and available follow-up were included. Stone composition was determined using morpho-spectroscopic analysis. Clinical and behavioral variables were collected from medical records. Recurrence was defined as a new stone event during follow-up. Time-to-event analysis was performed using Kaplan\u2013Meier estimates and Cox proportional hazards models. Results: A total of 962 patients were included, with a median follow-up of over three years. During this period, recurrence occurred in approximately one-third of patients. Uric acid stones were associated with a higher risk of recurrence compared with calcium oxalate monohydrate stones, while the effect size was moderate. Previous stone history and low fluid intake were also independently associated with recurrence. Other dietary variables did not retain statistical significance after adjustment. Conclusions: Recurrence in urolithiasis appears to reflect the combined effect of compositional, clinical, and behavioral factors. While certain variables are associated with increased risk, no single determinant fully explains recurrence patterns. These findings support a more individualized approach to risk assessment and follow-up.<\/jats:p>","DOI":"10.3390\/epidemiologia7040093","type":"journal-article","created":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T11:39:11Z","timestamp":1783078751000},"page":"93","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Epidemiological Determinants of Urolithiasis Recurrence: A Retrospective Cohort Study Integrating Stone Composition and Behavioral Factors"],"prefix":"10.3390","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4146-9131","authenticated-orcid":false,"given":"Marius","family":"Iv\u0103nu\u021b\u0103","sequence":"first","affiliation":[{"name":"Grigore T. Popa University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania"},{"name":"Department of Urology, \u201cDr. C.I. Parhon\u201d Clinical Hospital, 700503 Iasi, Romania"},{"name":"Center for Morphological and Spectroscopic Analysis of Urinary Stones \u201cMichel Daudon\u201d, 700503 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3453-1251","authenticated-orcid":false,"given":"Drago\u0219","family":"Puia","sequence":"additional","affiliation":[{"name":"Grigore T. Popa University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania"},{"name":"Department of Urology, \u201cDr. C.I. Parhon\u201d Clinical Hospital, 700503 Iasi, Romania"},{"name":"Center for Morphological and Spectroscopic Analysis of Urinary Stones \u201cMichel Daudon\u201d, 700503 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-6083-7822","authenticated-orcid":false,"given":"Mihaela","family":"Corlade-Andrei","sequence":"additional","affiliation":[{"name":"Grigore T. Popa University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania"},{"name":"Emergency Care Department, \u201cSf. Spiridon\u201d County University Emergency Hospital, 700111 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana-Maria","family":"Iv\u0103nu\u021b\u0103","sequence":"additional","affiliation":[{"name":"Emergency Care Department, \u201cSf. Spiridon\u201d County University Emergency Hospital, 700111 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6618-141X","authenticated-orcid":false,"given":"Bogdan","family":"Doroftei","sequence":"additional","affiliation":[{"name":"Grigore T. Popa University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania"},{"name":"Origyn Fertility Center, Palace Street No. 3C, 700032 Iasi, Romania"},{"name":"Clinical Hospital of Obstetrics and Gynecology \u201cCuza Voda\u201d, Cuza Voda Street No. 34, 700038 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Octavia","family":"Petrila","sequence":"additional","affiliation":[{"name":"Department of Radiology, \u201cDr. C.I. Parhon\u201d Clinical Hospital, 700503 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mihaela","family":"Nikolic","sequence":"additional","affiliation":[{"name":"Department of Physiology, University of Life Sciences Ion Ionescu de la Brad, 700490 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C\u0103t\u0103lin","family":"Pricop","sequence":"additional","affiliation":[{"name":"Grigore T. Popa University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania"},{"name":"Department of Urology, \u201cDr. C.I. Parhon\u201d Clinical Hospital, 700503 Iasi, Romania"},{"name":"Center for Morphological and Spectroscopic Analysis of Urinary Stones \u201cMichel Daudon\u201d, 700503 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"173","DOI":"10.4081\/aiua.2017.3.173","article-title":"Epidemiologic study of urolithiasis in seven countries of South-Eastern Europe: S.E.G.U.R. 1 study","volume":"89","author":"Karagiannis","year":"2017","journal-title":"Arch. Ital. Urol. 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