Study on Metabolic Differences and Microbiota Distribution in Patients with Infection-Induced Kidney Stones by Gender

Objective This study aims to investigate the distribution patterns of microbiota and stone composition in patients with infection-induced stones across different genders, and to elucidate the differences between stone composition and metabolism. Methods Clinical data from 355 patients with infection stones (confirmed by postoperative stone composition analysis) who were hospitalized and treated at our center from January 2016 to December 2023 were retrospectively analyzed. The collected data included preoperative mid-stream urine culture results, serum biochemical parameters, 24-hour urinary metabolic indices, and postoperative stone composition analysis. The patients were divided into two groups based on gender to analyze the distribution of stone composition and microbiota. Metabolic differences between the groups were assessed based on blood biochemical markers and 24-hour urinary metabolic test results. Results Of the 355 cases, struvite-carbonate apatite mixed stones were most frequent overall and in females (P < 0.05), while pure struvite stones dominated in males (P < 0.05). Microbiota distribution showed E. coli was most common in females and P. aeruginosa in males (P < 0.05). Females had significantly higher serum phosphorus, chlorine, and eGFR (P < 0.05), whereas males had higher blood urea nitrogen, creatinine, and uric acid (P < 0.05). Additionally, 24-hour urinary phosphorus, chlorine, and sodium excretions were greater in males (P < 0.05). Conclusion Significant gender differences exist in the microbiota distribution, stone composition, and metabolic characteristics of patients with infection-induced stones. Therefore, it is of great importance to improve metabolic evaluation and urine culture practices. Furthermore, this study suggests that male patients with infection stones have poorer renal function, necessitating more timely and effective clinical intervention.