Association between oxidative balance score and nephrolithiasis; a systematic review and meta-analysis

Introduction: Nephrolithiasis is a prevalent urological condition. Given the kidney’s vulnerability to oxidative stress-induced damage, exploring the relationship between the oxidative balance score (OBS) and nephrolithiasis formation holds significant clinical relevance. This study systematically reviews and meta-analysis the association between OBS and nephrolithiasis. Materials and Methods: A comprehensive literature search was conducted across ProQuest, PubMed, Embase, Web of Science, Cochrane, and Google Scholar through January 20, 2025, without time restrictions. Data were imported into SPSS 19 and analyzed using STATA 14. Results: A higher OBS was associated with a reduced risk of nephrolithiasis in the overall population (OR: 0.74, 95% CI: 0.70, 0.79), as well as in men (OR: 0.98, 95% CI: 0.96, 0.99) and women (OR: 0.98, 95% CI: 0.96, 0.99). Additionally, increasing OBS was inversely correlated with kidney stone risk across quartiles; quartile 2 (OR: 0.78, 95% CI: 0.80, 0.87), quartile 3 (OR: 0.75, 95% CI: 0.68, 0.83), and quartile 4 (OR: 0.68, 95% CI: 0.59, 0.77). Both dietary OBS (OR: 0.97, 95% CI: 0.96, 0.98) and lifestyle OBS (OR: 0.95, 95% CI: 0.90, 1.00) were associated with a lower risk of nephrolithiasis. Among hypertensive patients, a higher OBS correlated with reduced nephrolithiasis risk (OR: 0.97, 95% CI: 0.96, 0.99), whereas in diabetic patients, the association was not statistically significant (OR: 1.00, 95% CI: 0.96, 1.04). Conclusion: A higher total OBS, along with dietary and lifestyle OBS, was significantly linked to a lower risk of nephrolithiasis. Notably, increased OBS scores were consistently associated with a decreased likelihood of nephrolithiasis formation. Registration: This study has been compiled based on the PRISMA checklist, and its protocol was registered on the PROSPERO (ID: CRD42025643705) and Research Registry (UIN: reviewregistry1952) website.