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Song DY, Ceraolo C, Sandoval V, Jain RK, Quarrier SO. Gender Disparities in Quality of Life Outcomes Among Kidney Stone Formers. J Endourol 2024; 38:637-641. [PMID: 38613815 DOI: 10.1089/end.2024.0033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/15/2024] Open
Abstract
Purpose: This study investigates gender-based disparities in health-related quality of life (HRQOL) outcomes among kidney stone patients and explores potential contributing factors. Methods: A retrospective review of medical records at the University of Rochester Medical Center was conducted on 2199 new urolithiasis patients who completed the Wisconsin Stone Quality of Life Questionnaire (WISQOL) standardized on a 0 to 100 scale. Demographic and clinical data were collected. Statistical analyses included univariate tests, chi-squared tests, and multivariate linear regression. Results: Of the 2199 kidney stone patients, 1085 (49.3%) were women. Women reported significantly lower quality of life (QoL) scores compared with men (71.6 vs 80.7; p < 0.001), and this persisted across all domains, including social impact (80.2 vs 86.9; p < 0.001), emotional impact (67.3 vs 77.1; p < 0.001), disease impact (67.3 vs 77.1; p < 0.001), and impact vitality (62.6 vs 72.9; p < 0.001). Female gender was identified as an independent predictor of diminished QoL scores, along with younger age, symptomatic status, number of surgeries, and presence of a psychosocial comorbidity. Conclusions: Our findings suggest that women with kidney stones experience lower HRQOL compared with men, even accounting for clinical and demographic factors. Although this study provides preliminary insights, additional research is needed to validate these findings in broader and more varied populations.
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Affiliation(s)
- David Y Song
- University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
| | - Carl Ceraolo
- Department of Urology, University of Rochester Medical Center, Rochester, New York, USA
| | - Victor Sandoval
- Department of Urology, University of Rochester Medical Center, Rochester, New York, USA
| | - Rajat K Jain
- Department of Urology, University of Rochester Medical Center, Rochester, New York, USA
| | - Scott O Quarrier
- Department of Urology, University of Rochester Medical Center, Rochester, New York, USA
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Assad A, Raizenne BL, El Yamani MEM, Saud A, Bechis SK, Sur RL, Nakada SY, Streeper NM, Sivalingam S, Pais VM, Chew BH, Bird VG, Andonian S, Penniston KL, Bhojani N. The impact of kidney stone disease on quality of life in high-risk stone formers. BJU Int 2024; 133:570-578. [PMID: 38332669 DOI: 10.1111/bju.16294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2024]
Abstract
OBJECTIVE To assess the impact of kidney stone disease (KSD) and its treatment on the health-related quality of life (HRQOL) of high-risk stone formers with hyperparathyroidism, renal tubular acidosis, malabsorptive disease, and medullary sponge kidney. PATIENTS AND METHODS The Wisconsin Stone Quality of Life questionnaire was used to evaluate HRQOL in 3301 patients with a history of KSD from 16 institutions in North America between 2014 and 2020. Baseline characteristics and medical history were collected from patients, while active KSD was confirmed through radiological imaging. The high-risk group was compared to the remaining patients (control group) using the Wilcoxon rank-sum test. RESULTS Of 1499 patients with active KSD included in the study, the high-risk group included 120 patients. The high-risk group had significantly lower HRQOL scores compared to the control group (P < 0.01). In the multivariable analyses, medullary sponge kidney disease and renal tubular acidosis were independent predictors of poorer HRQOL, while alkali therapy was an independent predictor of better HRQOL (all P < 0.01). CONCLUSIONS Among patients with active KSD, high-risk stone formers had impaired HRQOL with medullary sponge kidney disease and renal tubular acidosis being independent predictors of poorer HRQOL. Clinicians should seek to identify these patients earlier as they would benefit from prompt treatment and prevention.
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Affiliation(s)
- Anis Assad
- Division of Urology, Centre Hospitalier de l'Université de Montréal, Montréal, Quebec, Canada
| | - Brendan L Raizenne
- Division of Urology, Centre Hospitalier de l'Université de Montréal, Montréal, Quebec, Canada
| | | | - Almousa Saud
- Division of Urology, Centre Hospitalier de l'Université de Montréal, Montréal, Quebec, Canada
| | - Seth K Bechis
- Department of Urology, University of California San Diego, San Diego, CA, USA
| | - Roger L Sur
- Department of Urology, University of California San Diego, San Diego, CA, USA
| | - Stephen Y Nakada
- Department of Urology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Necole M Streeper
- Department of Urology, Pennsylvania State University College of Medicine, Hershey, PA, USA
| | - Sri Sivalingam
- Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Vernon M Pais
- Urology Section, Dartmouth Hitchcock Medical Center, Lebanon, NH, USA
| | - Ben H Chew
- Department of Urologic Sciences, University of British Columbia, Vancouver, British Columbia, Canada
| | - Vincent G Bird
- Department of Urology, University of Florida College of Medicine, Gainesville, FL, USA
| | - Sero Andonian
- Division of Urology, McGill University Health Center, Montreal, Quebec, Canada
| | - Kristina L Penniston
- Department of Urology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Naeem Bhojani
- Division of Urology, Centre Hospitalier de l'Université de Montréal, Montréal, Quebec, Canada
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Wymer KM, Boddu SP, Choudry M, Narang G, Heidenberg DJ, Payne NG, Girardo M, Humphreys MR, Stern KL. Access to Care and Health Care Utilization Among Patients With Nephrolithiasis. Urology 2024; 187:8-14. [PMID: 38432429 DOI: 10.1016/j.urology.2023.11.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 11/12/2023] [Accepted: 11/28/2023] [Indexed: 03/05/2024]
Abstract
OBJECTIVE To characterize the impact of nephrolithiasis diagnosis and treatment on health care utilization and identify predictors of barriers to care in the patient population. METHODS We conducted a retrospective cohort study using the All of Us Database, a National Institutes of Health database targeting recruitment of underrepresented populations. Patients with a diagnosis of kidney stones were included and matched to a control group. Primary outcomes were patients' self-reported health care access and utilization. Univariable and multivariable regression analyses were performed. RESULTS 9173 patients with a diagnosis of nephrolithiasis were included and matched to 9173 controls without a diagnosis of nephrolithiasis. Patients with kidney stones were less likely to have had >1 year since last provider visit (1.7% vs 3.8%, P <.001), but did not report increased delays obtaining care (31%), inability to afford care (11.4%), or higher likelihood of skipping medications (12.9%). Among patients with stones, 1208 (13.2%) had been treated surgically. On multivariable analysis, younger age, female sex, lower income, lower education, non-insured status, and lower physical and mental health were all associated with delays obtaining care, difficulty affording care, skipping medications, and/or prolonged time since seeing a provider. CONCLUSION A diagnosis of nephrolithiasis and subsequent surgical intervention were not associated with an increase in patient-reported barriers to care. However, among patients with nephrolithiasis, younger, comorbid, female patients from lower socioeconomic status are at significant risk of being unable to access and utilize treatment.
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Affiliation(s)
| | - Sayi P Boddu
- Mayo Clinic Alix School of Medicine, Scottsdale, AZ.
| | | | - Gopal Narang
- Department of Urology, University of North Carolina, Chapel Hill, NC.
| | | | | | - Marlene Girardo
- Mayo Clinic Department of Qualitative Health Sciences, Scottsdale, AZ.
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Wei B, Tan W, He S, Yang S, Gu C, Wang S. Association between drinking status and risk of kidney stones among United States adults: NHANES 2007-2018. BMC Public Health 2024; 24:820. [PMID: 38491490 PMCID: PMC10941453 DOI: 10.1186/s12889-024-18307-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Accepted: 03/07/2024] [Indexed: 03/18/2024] Open
Abstract
OBJECTIVE This study aimed to investigate the relationship between drinking status and kidney stones occurrence among United States (US) adults who consume alcohol. METHODS We conducted a cross-sectional analysis using data from the National Health and Nutrition Examination Survey (NHANES 2007-2018). Questionnaires yielded information on alcohol consumption and kidney health. Drinking status was categorized into four groups-former, mild, moderate, and heavy-based on alcohol consumption patterns. The aim was to explore the relationship between drinking status and the prevalence of kidney stones occurrence. For this analysis, we examined a group of individuals diagnosed with kidney stones. With survey weights applied, the total weight of the group was 185,690,415. RESULTS We used logistic regression to measure the relationship between drinking status and the likelihood of developing kidney stones. In a fully adjusted model, former drinkers were less likely to have previously experienced kidney stones (OR 0.762, 95% CI 0.595-0.977, P < 0.05). In subgroup analysis, heavy alcohol consumption was associated with a significantly reduced likelihood of kidney stones occurrence in various populations. The adjusted odds ratios (with 95% confidence intervals) of kidney stones risk for heavy alcohol consumption were 0.745 (0.566-0.981) for young individuals, 0.566 (0.342-0.939) for older individuals, 0.708 (0.510-0.981) for individuals of white race, 0.468 (0.269-0.817) for individuals with underweight/normal BMI, 0.192 (0.066-0.560) for widowed people, 0.538 (0.343-0.843) for smoking individuals, 0.749 (0.595-0.941) for individuals without a cancer history, and 0.724 (0.566-0.925) for individuals without a stroke history. CONCLUSIONS In US adults who consume alcohol, a negative linear relationship is apparent between drinking status and the prevalence of kidney stones, with heavy drinking showing a lower prevalence compared to former drinkers. However, the causal relationship between drinking status and kidney stones requires further investigation in future research endeavors.
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Affiliation(s)
- Baian Wei
- The Second School of Clinical Medical , Guangzhou University of Chinese Medicine, Guangzhou, 510006, China
| | - Wenyue Tan
- The Second School of Clinical Medical , Guangzhou University of Chinese Medicine, Guangzhou, 510006, China
| | - Shuien He
- The Second School of Clinical Medical , Guangzhou University of Chinese Medicine, Guangzhou, 510006, China
| | - Shijian Yang
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, 510120, China
| | - Chiming Gu
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, 510120, China
| | - Shusheng Wang
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, 510120, China.
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Li S, Knoedler MA, Haas CR, Nakada SY, Penniston KL. Development and Preliminary Validation of the 6-Item Short Form of the Wisconsin Stone Quality of Life Questionnaire. Urology 2023; 177:48-53. [PMID: 37031845 DOI: 10.1016/j.urology.2023.03.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 03/20/2023] [Accepted: 03/27/2023] [Indexed: 04/11/2023]
Abstract
OBJECTIVE To develop a short form of the Wisconsin Stone Quality of Life (WISQOL): 1) identify the smallest subset of items from WSIQOL that accurately predict patients' health-related quality of life (HRQOL), and 2) in a clinical patient population, test these items-grouped together to form the WISQOL-short form (SF) - and assess its convergent validity. MATERIALS AND METHODS The items for the WISQOL-SF were identified based on classic item analysis theory. Patients who previously completed the original 28-item WISQOL were randomly split into 2 groups of equal size. Scores for the WISQOL were calculated for one group while those for the WISQOL-SF were calculated for the other. Cronbach's alpha coefficients were calculated. Impacts of demographic and clinical factors as well as stone and symptom status at the time of WISQOL completion were examined. RESULTS Patients (n = 740) who completed the WISQOL between 6/2017 and 11/2021 were included. Patients were 48% male, 54.1 ± 14.6 years old, and had a BMI of 31.2 ± 8.1. After item analysis and reduction, the six items ultimately included in the WISQOL-SF represented 2 of the 4 domains (social and emotional) of the original WISQOL. The internal consistency of the WISQOL-SF was similar to the original (Cronbach's alpha 0.943 vs. 0.973). No differences for health-related quality of life were found between groups (P = .567). CONCLUSION The WISQOL-SF demonstrated the expected differences for gender and between patients with and without stone-related symptoms at the time of WISQOL completion. The WISQOL-SF showed good consistency and produced similar HRQOL scores to the full-form WISQOL.
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Affiliation(s)
- Shuang Li
- Department of Urology, University of Wisconsin School of Medicine and Public Health, Madison, WI.
| | - Margaret A Knoedler
- Department of Urology, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Christopher R Haas
- Department of Urology, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Stephen Y Nakada
- Department of Urology, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Kristina L Penniston
- Department of Urology, University of Wisconsin School of Medicine and Public Health, Madison, WI
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Cabo J, Gelikman DG, Hsi RS. The Financial Burden of Nephrolithiasis and Predictors of Disease-specific Financial Toxicity. Urology 2023; 171:57-63. [PMID: 36252733 DOI: 10.1016/j.urology.2022.08.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 08/23/2022] [Accepted: 08/29/2022] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To characterize stone-related financial toxicity among US adults with kidney stones through validated questionnaires for financial toxicity and disease-specific health-related quality of life. MATERIALS AND METHODS We performed a cross-sectional survey of adults with kidney stone disease from the general population ascertained through a national registry of volunteers (ResearchMatch). A computer-based survey queried stone event history and related costs for medical care, disease-specific quality of life (WISQOL), and an 11-item measure of stone-related financial toxicity (COST-11 score). Multivariable logistic regression was performed to evaluate predictors of financial toxicity, defined as having a COST-11 score ≤20. RESULTS Of 942 responses, median COST-11 score was 29 (IQR 21-38), and 24.7% (N = 233) met criteria for disease-specific financial toxicity. Stone-formers with financial toxicity spent more out of pocket on stone-treatment in the previous year than patients with lower financial burden (P <.001) and were more likely to defer or delay recommended treatment due to anticipated cost (27% vs 3%; P <.001). Stone-specific financial toxicity was associated with poorer disease-specific health-related quality of life across all WISQOL domains (each P <.001). Multivariable logistic regression showed that female gender (OR 1.81; 95% CI 1.24-2.67), Medicaid compared to private insurance (OR 3.91; 95% CI 2.34-6.94), and stone passage in the previous year (OR 2.00; 95% CI 1.41-2.86) were independently associated with financial toxicity. CONCLUSION Approximately 1 in 4 individuals with kidney stone disease report disease-specific financial toxicity. These data suggest the financial burden of the condition may influence decision-making and associates with poorer disease-specific quality of life.
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Affiliation(s)
- Jackson Cabo
- Department of Urology, Vanderbilt University Medical Center, Nashville, TN.
| | | | - Ryan S Hsi
- Department of Urology, Vanderbilt University Medical Center, Nashville, TN
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7
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Mazzon G, Serafin E, Ferretti S, Claps F, Zhong W, Fiori C, Celentano G, Guarino GG, Zamengo D, Piasentin A, Creta M, Longo N, Dordoni R, Pavan N, Brancelli C, Cerruto MA, Antonelli A, Celia A. Validation of the Italian version of wisconsin stone quality of life (WISQOL): a prospective Italian multicenter study. Urolithiasis 2022; 51:7. [PMID: 36459218 PMCID: PMC9716497 DOI: 10.1007/s00240-022-01382-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 11/05/2022] [Indexed: 12/05/2022]
Abstract
Urolithiasis is a worldwide spread condition that affects patients' Health-Related Quality of Life (HRQOL), which measurement is an important tool for routine clinical and research practice. Disease-specific HRQOL measures demonstrated to perform better in assessing the effects of specific conditions. A disease-specific questionnaire for kidney stones, the WISQOL, has been validated in different languages, but an Italian version is still missing. Our aim is to produce and validate the Italian version of WISQOL (IT-WISQOL). Patients undergoing any elective treatment for upper urinary tract stones were enrolled. A multi-step process with forward- and back-translation was used to translate WISQOL into Italian. Patients were evaluated within 15 days pre-operatively and then at 30-, 90 days post-operatively and administered both IT-WISQOL and SF-36v2. Post-operative data such as 30 days postoperative complications, late stone-related events, successful status, and stone complexity were collected. Cronbach's α was used to evaluate the internal consistency of IT-WISQOL, while Spearman's rho was used for item and inter-domain correlations and IT-WISQOL with SF-36v2 correlation. We found excellent internal consistency across all domains (α ≥ 0.88), particularly when the total score is considered (α = 0.960). Test-retest reliability showed excellent results for the total questionnaire (Pearson correlation value: 0.85). The Inter-domain association ranged from 0.497 to 0.786. Convergent validity was confirmed by a good correlation with subdomains of the SF-36v2 measures. IT-WISQOL is a reliable tool to measure HRQOL in stone patients. It shows analog characteristics if compared to English WISQOL.
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Affiliation(s)
- Giorgio Mazzon
- Department of Urology, San Bassiano Hospital, Bassano del Grappa, Vicenza, Italy.
| | - Emanuele Serafin
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | | | - Francesco Claps
- Urology Clinic, Department of Medical, Surgical and Health Science, University of Trieste, Trieste, Italy
| | - Wen Zhong
- Department of Urology, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Cristian Fiori
- Department of Urology, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Turin, Italy
| | - Giuseppe Celentano
- Department of Neurosciences, Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II", Naples, Italy
| | | | - Davide Zamengo
- Department of Urology, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Turin, Italy
| | - Andrea Piasentin
- Urology Clinic, Department of Medical, Surgical and Health Science, University of Trieste, Trieste, Italy
| | - Massimiliano Creta
- Department of Neurosciences, Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II", Naples, Italy
| | - Nicola Longo
- Department of Neurosciences, Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II", Naples, Italy
| | - Roberta Dordoni
- Department of Urology, University Hospital of Parma, Parma, Italy
| | - Nicola Pavan
- Urology Clinic, Department of Medical, Surgical and Health Science, University of Trieste, Trieste, Italy
| | - Claudio Brancelli
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - Maria Angela Cerruto
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - Alessandro Antonelli
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - Antonio Celia
- Department of Urology, San Bassiano Hospital, Bassano del Grappa, Vicenza, Italy
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Thompson WR, Tolofari SK, Starmer B, Broome J, Garrod H, Agarwal K, Wong K, Panayi Z, Hughes K, Iskander M, Javed S, Kelly P, Lazarowicz H, Calvert RC. Patient-reported outcome measures (PROMs) in stone surgery: A multi-centre study of patient experience of flexible ureteroscopy (fURS) versus extracorporeal shockwave lithotripsy (SWL). JOURNAL OF CLINICAL UROLOGY 2022. [DOI: 10.1177/20514158221135692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Objectives: To compare patient-reported outcome measures (PROMs) for patients with symptomatic renal stone disease treated by flexible ureterorenoscopy (fURS) and shockwave lithotripsy (SWL) Introduction: Historically, surgical outcomes are measured by surgeon-specific outcomes such as ‘stone-free rates’. More recently, there is increasing emphasis on PROMs to ascertain a patient’s perspective of their own surgical outcome. Despite this, the literature in reference to renal stone-specific PROMs following stone treatment remains limited. Methods: Data were collected in a prospective multi-centre study. Patients undergoing fURS or SWL were asked to complete the validated Cambridge Renal Stone Patient Reported Outcome Measure ( CReSP) on the day of initial treatment and at weeks 1, 6 and 12 post-operatively. Results: Data were collected for 119 patients. Three were excluded as stone metric and demographic details were incomplete. Sixty underwent SWL and 56 underwent fURS. Median stone size was 7.52 mm. There were no significant differences in baseline PROM scores between the treatment groups. At 1 week, the PROM scores were significantly higher in the fURS group compared to SWL (27.40 ± 0.85sd versus 22.51 ± 1.07sd; p < 0.05). However, at 6 and 12 weeks, the PROM scores were significantly lower in the fURS group (18.51 ± 2.27sd versus 23.67 ± 1.30sd; p < 0.05) and (17.01 ± 2.29sd versus 22.49 ± 1.49sd; p < 0.05), respectively. By week 12, overall scores for anxiety and social factors were more favourable in the fURS cohort. Conclusion: Our study suggests that fURS is associated with a short-lived increase in morbidity in comparison with SWL, which may be due to ureteric stenting in the majority of patients post-operatively. However, fURS patients appear to report significantly better PROM scores in the longer term. This appears to be associated with more favourable anxiety and social factor scoring over the treatment period. Level of evidence: Not applicable.
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Affiliation(s)
- William R Thompson
- Department of Urology, Royal Liverpool and Broadgreen University Hospitals NHS Trust, Royal Liverpool University Hospital, UK
| | | | - Ben Starmer
- Department of Urology, Mid Cheshire Hospitals NHS Foundation Trust, UK
| | - James Broome
- Department of Urology, St Helens and Knowsley Teaching Hospitals NHS Trust, UK
| | - Huw Garrod
- Department of Urology, Wrexham Maelor Hospital, UK
| | | | - Kee Wong
- Department of Urology, Arrowe Park Hospital, UK
| | - Zoe Panayi
- Department of Urology, Arrowe Park Hospital, UK
| | - Kaylie Hughes
- Department of Urology, St Helens and Knowsley Teaching Hospitals NHS Trust, UK
| | - Morkos Iskander
- Department of Urology, Royal Liverpool and Broadgreen University Hospitals NHS Trust, Royal Liverpool University Hospital, UK
| | - Saqib Javed
- Department of Urology, Royal Liverpool and Broadgreen University Hospitals NHS Trust, Royal Liverpool University Hospital, UK
| | - Pat Kelly
- Department of Urology, Royal Liverpool and Broadgreen University Hospitals NHS Trust, Royal Liverpool University Hospital, UK
| | - Henry Lazarowicz
- Department of Urology, Royal Liverpool and Broadgreen University Hospitals NHS Trust, Royal Liverpool University Hospital, UK
| | - Rob C Calvert
- Department of Urology, Royal Liverpool and Broadgreen University Hospitals NHS Trust, Royal Liverpool University Hospital, UK
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9
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Johnston SS, Chen BPH, Rai P, Grange P, Dwarakanathan HR, Amos T, Johnson BH, Ghosh SK, Buchholz N. Incremental Healthcare Cost Implications of Retreatment Following Ureteroscopy or Percutaneous Nephrolithotomy for Upper Urinary Tract Stones: A Population-Based Study of Commercially-Insured US Adults. MEDICAL DEVICES-EVIDENCE AND RESEARCH 2022; 15:371-384. [DOI: 10.2147/mder.s384823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 10/28/2022] [Indexed: 11/10/2022] Open
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10
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Raizenne B, Deyirmendjian C, Bechis SK, Sur RL, Nakada SY, Antonelli JA, Streeper N, Sivalingam S, Viprakasit D, Averch TD, Landman J, Chi T, Pais VM, Chew BH, Bird V, Andonian S, Canvasser NE, Harper JD, Penniston KL, Bhojani N. The duration of stone disease and the impact of a stone event on patients' quality of life. J Endourol 2022; 36:1371-1376. [PMID: 35722905 DOI: 10.1089/end.2021.0897] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION With a 5-year stone recurrence rate of 30-50%, kidney stone formers are subject to significant morbidity which negatively impacts their Health Related Quality of Life (HRQOL). We sought to determine the impact of age of kidney stone onset, duration of stone disease, and kidney stone event (surgery or stone passage) on patients' individual HRQOL by querying the validated and prospectively collected Wisconsin Stone Quality of Life (WISQOL) database. MATERIALS AND METHODS Cross-sectional data were obtained from a total of 2,438 kidney stone formers from 14 institutions in North America who completed the WISQOL questionnaire from 2014 to 2019. The 28-question survey has a 1-5 point scale for each item (total score range 0-140). Multivariable linear regression models assessed the impact of age of kidney stone onset, duration of stone disease and time since most recent surgery or stone passage on HRQOL. RESULTS Of 2,438 patients, older age at kidney stone onset and longer duration of disease were both independent predictors of better WISQOL (β=0.33 points/year; CI 0.17-0.49; p<0.001 and β=0.50 points/year; CI 0.32-0.68; p<0.001, respectively). Of 1,376 patients with surgery between 2010-2019, increased time since most recent surgery was an independent predictor of better WISQOL scores (β = 2.28 points/year; CI: 1.47-3.10; p=<0.001). Of 1,027 patients with spontaneous stone passage between 2010-2019, increased time since most recent stone passage was an independent predictor of better WISQOL scores (β = 1.59 points/year; CI: 0.59-2.59; p=<0.05). CONCLUSION Our study demonstrates that older age of onset, longer duration of disease, increase time from most recent surgery or stone passage were independent predictors of better HRQOL in kidney stone formers. Results of future studies that focus on optimizing stone related modifiable risk factors to decrease the amount of recurrent stone episodes and thus the need for recurrent surgeries will be essential.
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Affiliation(s)
- Brendan Raizenne
- Centre hospitalier de l'Université de Montréal, Division of Urology, 900 rue saint-denis, Montréal, Quebec, Canada, H2X 0A9;
| | - Claudia Deyirmendjian
- Université de Montréal, 5622, Medicine, 2900 Boulevard Edouard-Montpetit, Montreal, Montreal, Quebec, Canada, H3T 1J4;
| | - Seth K Bechis
- University of California San Diego Health System, 21814, Urology, San Diego, California, United States;
| | - Roger L Sur
- UC San Diego, 8784, Urology, Department of Urology, 200 Arbor Drive #8897, San Diego, California, United States, 92130.,UC San Diego, 8784, Roger Sur, Department of Urology, 200 Arbor Drive #8897, San Diego, California, United States, 92130;
| | | | - Jodi A Antonelli
- UT Southwestern Medical Center, Urology, 5323 Harry Hines Blvd J8.106, Dallas, Texas, United States, 75390-9110;
| | - Nicole Streeper
- The Pennsylvania State University College of Medicine, 12310, Division of Urology, Hershey, Pennsylvania, United States;
| | - Sri Sivalingam
- University of Wisconsin, Urology, 3108 Bluff Street, apt 5, Madison, Wisconsin, United States, 53705;
| | - Davis Viprakasit
- UNC, Urology, 2114 POB, Campus Box 7235, Chapel Hill, North Carolina, United States, 27599;
| | - Timothy D Averch
- Palmetto Health USC Medical Group, Dept. of Surgery; Division of Urology, 2 Richmond Medical Park Drive - Ste 306, Columbia, South Carolina, United States, 29203.,CELL: 412-956-5226;
| | - Jaime Landman
- University of California Irvine, Urology, 333 City Blvd West, Orange, California, United States, 92868;
| | - Thomas Chi
- University of California San Francisco, Urology, 400 Parnassus Ave, 6th floor Urology Clinics A638, San Francisco, California, United States, 94143;
| | - Vernon M Pais
- Dartmouth Hitchcock Medical Center, Urology, Lebanon, New Hampshire, United States;
| | - Ben H Chew
- University of British Columbia, Urologic Sciences, Level 6, 2775 Laurel st., Level 6 - 2775 Laurel St, Vancouver, British Columbia, Canada, V5Z 1M9.,University of British Columbia, 8166, Urologic Sciences, 2775 Laurel St, Level 6, Vancouver, British Columbia, Canada, V5Z 1M9;
| | - Vincent Bird
- University of Florida, Urology, 1600 SW Archer Road, Box 100247, Gainesville, Florida, United States, 32610;
| | - Sero Andonian
- McGill University Health Centre, 54473, Division of Urology, Montreal, Quebec, Canada;
| | - Noah E Canvasser
- University of California Davis Health System, 70083, Urologic Surgery, 4860 Y Street, Suite 3500, Sacramento, California, United States, 95817.,United States;
| | | | - Kristina L Penniston
- University of Wisconsin School of Medicine and Public Health, Urology, 1685 Highland Avenue, 3258 MFCB, Madison, Wisconsin, United States, 53705-2281;
| | - Naeem Bhojani
- Centre Hospitalier de L'Universite de Montreal, 25443, Urology, 900 St. Denis street, Pavillon R, R08.474, Montreal, Quebec, Canada, H2X 0A9;
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11
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Seib CD, Ganesan C, Arnow KD, Pao AC, Leppert JT, Barreto NB, Kebebew E, Kurella Tamura M. Kidney Stone Events Following Parathyroidectomy vs Nonoperative Management for Primary Hyperparathyroidism. J Clin Endocrinol Metab 2022; 107:e2801-e2811. [PMID: 35363858 PMCID: PMC9202696 DOI: 10.1210/clinem/dgac193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Indexed: 11/19/2022]
Abstract
CONTEXT Primary hyperparathyroidism (PHPT) is associated with an increased risk of kidney stones. Few studies account for PHPT severity or stone risk when comparing stone events after parathyroidectomy vs nonoperative management. OBJECTIVE Compare the incidence of kidney stone events in PHPT patients treated with parathyroidectomy vs nonoperative management. DESIGN Longitudinal cohort study with propensity score inverse probability weighting and multivariable Cox proportional hazards regression. SETTING Veterans Health Administration integrated health care system. PATIENTS A total of 44 978 patients with > 2 years follow-up after PHPT diagnosis (2000-2018); 5244 patients (11.7%) were treated with parathyroidectomy. MAIN OUTCOMES MEASURE Clinically significant kidney stone event. RESULTS The cohort had a mean age of 66.0 years, was 87.8% male, and 66.4% White. Patients treated with parathyroidectomy had higher mean serum calcium (11.2 vs 10.8mg/dL) and were more likely to have a history of kidney stone events. Among patients with baseline history of kidney stones, the unadjusted incidence of ≥ 1 kidney stone event was 30.5% in patients managed with parathyroidectomy (mean follow-up, 5.6 years) compared with 18.0% in those managed nonoperatively (mean follow-up, 5.0 years). Patients treated with parathyroidectomy had a higher adjusted hazard of recurrent kidney stone events (hazard ratio [HR], 1.98; 95% CI, 1.56-2.51); however, this association declined over time (parathyroidectomy × time: HR, 0.80; 95% CI, 0.73-0.87). CONCLUSION In this predominantly male cohort with PHPT, patients treated with parathyroidectomy continued to be at higher risk of kidney stone events in the immediate years after treatment than patients managed nonoperatively, although the adjusted risk of stone events declined with time, suggesting a benefit to surgical treatment.
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Affiliation(s)
- Carolyn D Seib
- Correspondence: Carolyn Dacey Seib, MD, MAS, Stanford University, 300 Pasteur Dr, H3680, Stanford, CA 94305, USA.
| | - Calyani Ganesan
- Division of Nephrology, Stanford University School of Medicine, Palo Alto, CA 94305, USA
| | - Katherine D Arnow
- Stanford–Surgery Policy Improvement Research and Education Center, Department of Surgery, Stanford University School of Medicine, Palo Alto, CA 94304, USA
| | - Alan C Pao
- Division of Nephrology, Stanford University School of Medicine, Palo Alto, CA 94305, USA
- Department of Urology, Stanford University School of Medicine, Palo Alto, CA 94305, USA
| | - John T Leppert
- Division of Nephrology, Stanford University School of Medicine, Palo Alto, CA 94305, USA
- Department of Urology, Stanford University School of Medicine, Palo Alto, CA 94305, USA
| | - Nicolas B Barreto
- Stanford–Surgery Policy Improvement Research and Education Center, Department of Surgery, Stanford University School of Medicine, Palo Alto, CA 94304, USA
| | - Electron Kebebew
- Department of Surgery, Stanford University School of Medicine, Palo Alto, CA 94305, USA
| | - Manjula Kurella Tamura
- Geriatric Research, Education and Clinical Center, Veterans Affairs Palo Alto, Palo Alto, CA 94304, USA
- Division of Nephrology, Stanford University School of Medicine, Palo Alto, CA 94305, USA
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12
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Lin LH, Wang SB, Xu WQ, Hu Q, Zhang P, Ke YF, Huang JH, Ding KR, Li XL, Hou CL, Jia FJ. Subjective cognitive decline symptoms and its association with socio-demographic characteristics and common chronic diseases in the southern Chinese older adults. BMC Public Health 2022; 22:127. [PMID: 35042501 PMCID: PMC8767737 DOI: 10.1186/s12889-022-12522-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 01/03/2022] [Indexed: 11/10/2022] Open
Abstract
Background Subjective cognitive decline (SCD) may be the first symptomatic manifestation of Alzheimer’s disease, but information on its health correlates is still sparse in Chinese older adults. This study aimed to estimate SCD symptoms and its association with socio-demographic characteristics, common chronic diseases among southern Chinese older adults. Methods Participants aged 60 years and older from 7 communities and 2 nursing homes in Guangzhou were recruited and interviewed with standardized assessment tools. Pittsburgh Sleep Quality Index (PSQI), Patient Health Questionnaire–9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) were used to measure poor sleep quality, depression symptoms and anxiety symptoms. The SCD symptoms were measured by SCD questionnaire 9 (SCD-Q9) which ranged from 0 to 9 points, with a higher score indicating increased severity of the SCD. Participants were divided into low score group (SCD-Q9 score ≤ 3) and higher score group (SCD-Q9 score > 3). Chi-square tests and multivariate logistic regression analysis were used for exploring the influences of different characteristics of socio-demographic and lifestyle factors on SCD symptoms. Univariate and multivariate logistic regression analysis were applied to explore the association between SCD symptoms with common chronic diseases. Results A total of 688 participants were included in our analysis with a mean age of 73.79 (SD = 8.28, range: 60–101), while 62.4% of the participants were females. The mean score of the SCD-Q9 was 3.81 ± 2.42 in the whole sample. A total of 286 participants (41.6%) were defined as the low score group (≤3 points), while 402 participants (58.4%) were the high score group (> 3 points). Multivariate logistic regression analysis revealed that female (OR = 1.99, 95%CI: 1.35–2.93), primary or lower education level (OR = 2.58, 95%CI: 1.38–4.83), nursing home (OR = 1.90, 95%CI: 1.18–3.05), napping habits (OR = 1.59, 95%CI: 1.06–2.40), urolithiasis (OR = 2.72, 95%CI: 1.15–6.40), gout (OR = 2.12, 95%CI: 1.14–3.93), poor sleep quality (OR = 1.93, 95%CI: 1.38–2.71), depression symptoms (OR = 3.01, 95%CI: 1.70–5.34) and anxiety symptoms (OR = 3.11, 95%CI: 1.29–7.46) were independent positive related to high SCD-Q9 score. On the other hand, tea-drinking habits (OR = 0.64, 95%CI: 0.45–0.92), current smoking (OR = 0.46, 95%CI: 0.24–0.90) were independent negative related to high SCD-Q9 score. Conclusions Worse SCD symptoms were closely related to common chronic diseases and socio-demographic characteristics. Disease managers should pay more attention to those factors to early intervention and management for SCD symptoms among southern Chinese older adults.
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13
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Betz M. Whole Diet Approach to Calcium Oxalate Kidney Stone Prevention. J Ren Nutr 2022; 32:e11-e17. [PMID: 34980366 DOI: 10.1053/j.jrn.2021.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Accepted: 10/22/2021] [Indexed: 11/11/2022] Open
Affiliation(s)
- Melanie Betz
- Chronic Kidney Disease Nutrition & Education Specialist, University of Chicago Medicine - Section of Nephrology, Chicago, Illinois.
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14
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Noh TI, Hong J, Kang SH, Jung J. Association of meteorological factors and ambient air pollution on medical care utilization for urolithiasis: a population-based time-series study. BMC Nephrol 2021; 22:402. [PMID: 34856940 PMCID: PMC8638132 DOI: 10.1186/s12882-021-02614-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 11/08/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To identify the association of meteorological factors/ambient air pollutants with medical care utilization for urolithiasis and estimate the effect size/time lags. METHODS This is a population-based time-series analysis of 300,000 urolithiasis cases from eight large metropolitan areas in Korea. Seventeen meteorological factors and ambient air pollutants were measured daily during 2002-2017 for each metropolis. Data on daily medical utilization owing to urolithiasis were collected. A generalized additive model was used while factoring in the nonlinear relationship between meteorological factors/ambient air pollutants and urolithiasis and a time lag of ≤10 days. A multivariate analysis was performed. Backward elimination with an Akaike information criterion was used for fitting the multivariate model. RESULTS Urolithiasis was significantly associated with average temperature, diurnal temperature range, sunshine duration, particulate matter (PM) ≤2.5 μm, and carbon monoxide (CO) levels. The incidence of ureteral stones was positively correlated with average temperature, PM ≤2.5 μm level, and CO level (time lags 0-9, 2-4, and 0-9 days, respectively). The incidence of renal stones was positively correlated with PM ≤2.5 μm and CO levels (time lags 2-4 and 0-9 days, respectively). PM ≤2.5 μm (0.05 and 0.07% per 10 μg/m3) and CO (2.05 and 2.25% per 0.1 ppm) conferred the highest excess risk on ureteral and renal stones. CONCLUSIONS Urolithiasis is affected by various meteorological factors and ambient air pollutants, PM ≤2.5 μm, and CO levels may be novel potential risk factors for this condition.
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Affiliation(s)
- Tae Il Noh
- Department of Urology, Korea University School of Medicine, Seoul, Republic of Korea
| | - Jinwook Hong
- Artificial Intelligence and Big-Data Convergence Center, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Seok Ho Kang
- Department of Urology, Korea University School of Medicine, Seoul, Republic of Korea
| | - Jaehun Jung
- Artificial Intelligence and Big-Data Convergence Center, Gachon University Gil Medical Center, Incheon, Republic of Korea. .,Department of Preventive Medicine, Gachon University College of Medicine, 38-13, Dokjeom-ro 3, 21565, Incheon, Republic of Korea.
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15
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Lee JY, Andonian S, Bhojani N, Bjazevic J, Chew BH, De S, Elmansy H, Lantz-Powers AG, Pace KT, Schuler TD, Singal RK, Wang P, Ordon M. Canadian Urological Association guideline: Management of ureteral calculi - Abridged version. Can Urol Assoc J 2021; 15:383-393. [PMID: 34847343 PMCID: PMC8631858 DOI: 10.5489/cuaj.7652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Jason Y. Lee
- Division of Urology, Department of Surgery, University of Toronto, Toronto, ON, Canada
| | - Sero Andonian
- Division of Urology, Department of Surgery, McGill University Health Centre, Montreal, QC, Canada
| | - Naeem Bhojani
- Department of Urology, Université de Montréal, Montreal, QC, Canada
| | - Jennifer Bjazevic
- Division of Urology, Department of Surgery, Western University, London, ON, Canada
| | - Ben H. Chew
- Department of Urologic Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Shubha De
- Division of Urology, Department of Surgery, University of Alberta, Edmonton, AB, Canada
| | - Hazem Elmansy
- Urology, Northern Ontario School of Medicine, Thunder Bay, ON, Canada
| | | | - Kenneth T. Pace
- Division of Urology, Department of Surgery, University of Toronto, Toronto, ON, Canada
| | - Trevor D. Schuler
- Division of Urology, Department of Surgery, University of Alberta, Edmonton, AB, Canada
| | - Rajiv K. Singal
- Division of Urology, Department of Surgery, University of Toronto, Toronto, ON, Canada
| | - Peter Wang
- London Health Sciences Centre, Western University, London, ON, Canada
| | - Michael Ordon
- Division of Urology, Department of Surgery, University of Toronto, Toronto, ON, Canada
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16
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Innes GD, Teichman JMH, Scheuermeyer FX, McRae AD, Grafstein E, Andruchow J, Cheng L, Law MR. Does early intervention improve outcomes for patients with acute ureteral colic? CAN J EMERG MED 2021; 23:679-686. [PMID: 34491558 DOI: 10.1007/s43678-020-00016-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 08/26/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Early surgical intervention is increasingly employed for patients with ureteral colic, but guidelines and current practice are variable. We compared 60-day outcomes for matched patients undergoing early intervention vs. spontaneous passage. METHODS This multicentre propensity-matched cohort analysis used administrative data and chart review to study all eligible emergency department (ED) patients with confirmed 2.0-9.9 mm ureteral stones. Those having planned stone intervention within 5 days comprised the intervention cohort. Controls attempting spontaneous passage were matched to intervention patients based on age, sex, stone width, stone location, hydronephrosis, ED site, ambulance arrival and acuity level. The primary outcome was treatment failure, defined as rescue intervention or hospitalization within 60 days, using a time to event analysis. Secondary outcome was ED revisit rate. RESULTS Among 1154 matched patients, early intervention did not reduce the risk of treatment failure (adjusted hazard ratio 0.94; P = 0.61). By 60 days, 21.8% of patients in both groups experienced the composite primary outcome (difference 0.0%; 95% confidence interval - 4.8 to 4.8%). Intervention patients required more hospitalizations (20.1% vs. 12.8%; difference 7.3%; 95% CI 3.0-11.5%) and ED revisits (36.1% vs. 25.5%; difference 10.6%; 95% CI 5.3-15.9%), but (insignificantly) fewer rescue interventions (18.9% vs. 21.3%; difference - 2.4%; 95% CI - 7.0 to 2.2%). CONCLUSIONS In matched patients with 2.0-9.9 mm ureteral stones, early intervention was associated with similar rates of treatment failure but greater patient morbidity, evidenced by hospitalizations and emergency revisits. Physicians should adopt a selective approach to interventional referral and consider that spontaneous passage probably provides better outcomes for many low-risk patients.
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Affiliation(s)
- Grant D Innes
- Department of Emergency Medicine and Department of Community Health Sciences, University of Calgary, Room C231, Foothills Medical Centre, 1403, 29 Street NW, Calgary, AB, T2N 2T9, Canada.
| | - Joel M H Teichman
- Department of Urologic Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Frank X Scheuermeyer
- Department of Emergency Medicine and Center for Healthcare Evaluation and Outcome Sciences, St Paul's Hospital, University of British Columbia, Vancouver, BC, Canada
| | - Andrew D McRae
- Department of Emergency Medicine and Department of Community Health Sciences, University of Calgary, Room C231, Foothills Medical Centre, 1403, 29 Street NW, Calgary, AB, T2N 2T9, Canada
| | - Eric Grafstein
- Department of Emergency Medicine and Center for Healthcare Evaluation and Outcome Sciences, St Paul's Hospital, University of British Columbia, Vancouver, BC, Canada
| | - James Andruchow
- Department of Emergency Medicine and Department of Community Health Sciences, University of Calgary, Room C231, Foothills Medical Centre, 1403, 29 Street NW, Calgary, AB, T2N 2T9, Canada
| | - Lucy Cheng
- Centre for Health Services and Policy Research, School for Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Michael R Law
- Centre for Health Services and Policy Research, School for Population and Public Health, University of British Columbia, Vancouver, BC, Canada
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17
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Crivelli JJ, Maalouf NM, Paiste HJ, Wood KD, Hughes AE, Oates GR, Assimos DG. Disparities in Kidney Stone Disease: A Scoping Review. J Urol 2021; 206:517-525. [PMID: 33904797 PMCID: PMC8355087 DOI: 10.1097/ju.0000000000001846] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/14/2021] [Indexed: 11/27/2022]
Abstract
PURPOSE We reviewed the available evidence regarding health disparities in kidney stone disease to identify knowledge gaps in this area. MATERIALS AND METHODS A literature search was conducted using PubMed®, Embase® and Scopus® limited to articles published in English from 1971 to 2020. Articles were selected based on their relevance to disparities in kidney stone disease among adults in the United States. RESULTS Several large epidemiological studies suggest disproportionate increases in incidence and prevalence of kidney stone disease among women as well as Black and Hispanic individuals in the United States, whereas other studies of comparable size do not report racial and ethnic demographics. Numerous articles describe disparities in imaging utilization, metabolic workup completion, analgesia, surgical intervention, stone burden at presentation, surgical complications, followup, and quality of life based on race, ethnicity, socioeconomic status and place of residence. Differences in urinary parameters based on race, ethnicity and socioeconomic status may be explained by both dietary and physiological factors. All articles assessed had substantial risk of selection bias and confounding. CONCLUSIONS Health disparities are present in many aspects of kidney stone disease. Further research should focus not only on characterization of these disparities but also on interventions to reduce or eliminate them.
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Affiliation(s)
- Joseph J Crivelli
- Department of Urology, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama
| | - Naim M Maalouf
- Department of Internal Medicine and Charles and Jane Pak Center for Mineral Metabolism and Clinical Research, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Henry J Paiste
- Department of Urology, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama
| | - Kyle D Wood
- Department of Urology, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama
| | - Amy E Hughes
- Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Gabriela R Oates
- Department of Pediatrics, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama
| | - Dean G Assimos
- Department of Urology, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama
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18
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Ito K, Takahashi T, Somiya S, Kanno T, Higashi Y, Yamada H. Predictors of Repeat Surgery and Stone-related Events After Flexible Ureteroscopy for Renal Stones. Urology 2021; 154:96-102. [PMID: 33667526 DOI: 10.1016/j.urology.2021.02.025] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 02/11/2021] [Accepted: 02/22/2021] [Indexed: 12/24/2022]
Abstract
OBJECTIVES To evaluate the risk of repeat surgery and stone-related events after flexible ureteroscopy (fURS) for renal stones, and to identify their predictive factors. PATIENTS AND METHODS This was a single-center, retrospective cohort study of patients (n = 664) who underwent fURS for renal stones with or without concomitant ureteral stones between January 2012 and December 2019. The primary outcomes were time to ipsilateral stone-related surgical intervention and any stone-related event (including ipsilateral renal colic, symptomatic ureteral calculi, obstructive urinary tract infection, and surgical intervention). RESULTS During median follow-up of 31.1 months, 103 (15.5%) and 135 (20.3%) patients experienced surgical intervention and any stone-related event, respectively. The estimated 2-year intervention-free survival and stone-event-free survival was 86.9% and 81.6%, respectively. On Cox multivariate analysis, younger age (hazard ratio [HR] 0.96), history of stone surgery (HR 2.17), larger preoperative stone burden (HR 1.03), and larger residual fragment (HR 1.09) showed an association with future intervention. Use of the four identified risk factors (age ≤60, history of stone surgery, stone burden ≥20 mm, and residual fragment ≥4 mm) allowed stratification of patients based on the risk of future intervention (low [score: 0-1], intermediate [2], and high [3-4] risk). The estimated 2-year intervention-free survival rates in low-, intermediate-, and high-risk groups were 96.2%, 86.4%, and 71.3%, respectively. CONCLUSION Patients undergoing fURS are at risk of future ipsilateral surgical intervention and stone-related events. Our simple predictive tool can facilitate treatment decision-making by identifying patients who are at high risk of recurrence.
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Affiliation(s)
- Katsuhiro Ito
- Department of Urology, Ijinkai Takeda General Hospital, Ishida Fushimi-ku, Kyoto, Japan.
| | - Toshifumi Takahashi
- Department of Urology, Ijinkai Takeda General Hospital, Ishida Fushimi-ku, Kyoto, Japan
| | - Shinya Somiya
- Department of Urology, Ijinkai Takeda General Hospital, Ishida Fushimi-ku, Kyoto, Japan
| | - Toru Kanno
- Department of Urology, Ijinkai Takeda General Hospital, Ishida Fushimi-ku, Kyoto, Japan
| | - Yoshihito Higashi
- Department of Urology, Ijinkai Takeda General Hospital, Ishida Fushimi-ku, Kyoto, Japan
| | - Hitoshi Yamada
- Department of Urology, Ijinkai Takeda General Hospital, Ishida Fushimi-ku, Kyoto, Japan
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19
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Tapiero S, Limfuco L, Bechis SK, Sur RL, Penniston KL, Nakada SY, Antonelli JA, Streeper NM, Sivalingam S, Viprakasit DP, Averch TD, Okhunov Z, Patel RM, Chi T, Pais VM, Chew BH, Bird VG, Andonian S, Bhojani N, Canvasser NE, Landman J. The impact of the number of lifetime stone events on quality of life: results from the North American Stone Quality of Life Consortium. Urolithiasis 2021; 49:321-326. [PMID: 33409555 DOI: 10.1007/s00240-020-01238-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 12/17/2020] [Indexed: 11/28/2022]
Abstract
To evaluate the impact of chronic stone recurrence on an individual's quality of life using the validated Wisconsin Stone Quality of Life (WISQOL) questionnaire. We collected cross-sectional data on patients with kidney stones from 14 institutions in North America. A stone event was defined as renal colic, stone-related procedure or emergency department visit. The regression analyses using general linear models and pairwise comparison determined the impact of the number of stone events on quality of life. The median number of stone events among the 2205 patients who completed the questionnaire was 3 (IQR 1-6). The mean total score was 107.4 ± 28.7 (max 140 points). The number of lifetime stone events was an independent predictor of lower quality of life (p < 0.001), specifically, score declined significantly beyond five events. Compared with patients who experienced a single stone event, there was a 0.4, 2.5, and 6.9 point decline in the adjusted mean WISQOL score after 2-5, 6-10, or > 10 events, respectively. The cumulative number of lifetime stone events was associated with a lower quality of life when more than five stone events were occurred. These findings underscore the importance of efforts to determine the underlying metabolic etiology of urolithiasis in the recurrent stone former, and the institution of a regimen to place their stone disease in remission.
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Affiliation(s)
- Shlomi Tapiero
- Department of Urology, University of California Irvine, 333 City Blvd W, Suite 2100, Orange, CA, 92868, USA.
| | - Luke Limfuco
- Department of Urology, University of California Irvine, 333 City Blvd W, Suite 2100, Orange, CA, 92868, USA
| | - Seth K Bechis
- Department of Urology, University of California San Diego, San Diego, CA, USA
| | - Roger L Sur
- Department of Urology, University of California San Diego, San Diego, CA, USA
| | - Kristina L Penniston
- Department of Urology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Stephen Y Nakada
- Department of Urology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Jodi A Antonelli
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Necole M Streeper
- Division of Urology, Pennsylvania State University College of Medicine, Hershey, PA, USA
| | - Sri Sivalingam
- Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Davis P Viprakasit
- Department of Urology, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Timothy D Averch
- Department of Urology, Palmetto Health USC Medical Group, Columbia, SC, USA
| | - Zhamshid Okhunov
- Department of Urology, University of California Irvine, 333 City Blvd W, Suite 2100, Orange, CA, 92868, USA
| | - Roshan M Patel
- Department of Urology, University of California Irvine, 333 City Blvd W, Suite 2100, Orange, CA, 92868, USA
| | - Thomas Chi
- Department of Urology, University of California San Francisco, San Francisco, CA, USA
| | - Vernon M Pais
- Urology Section, Dartmouth Hitchcock Medical Center, Lebanon, NH, USA
| | - Ben H Chew
- Department of Urologic Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Vincent G Bird
- Department of Urology, University of Florida College of Medicine, Gainesville, FL, USA
| | - Sero Andonian
- Division of Urology, McGill University Health Center, Montreal, QC, Canada
| | - Naeem Bhojani
- Division of Urology, University of Montreal, Montreal, QC, Canada
| | - Noah E Canvasser
- Department of Urology, University of California Davis, Sacramento, CA, USA
| | - Jaime Landman
- Department of Urology, University of California Irvine, 333 City Blvd W, Suite 2100, Orange, CA, 92868, USA
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20
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Nguyen DD, Luo JW, Lu XH, Bechis SK, Sur RL, Nakada SY, Antonelli JA, Streeper NM, Sivalingam S, Viprakasit DP, Averch TD, Landman J, Chi T, Pais VM, Chew BH, Bird VG, Andonian S, Canvasser NE, Harper JD, Penniston KL, Bhojani N. Estimating the health-related quality of life of kidney stone patients: initial results from the Wisconsin Stone Quality of Life Machine-Learning Algorithm (WISQOL-MLA). BJU Int 2020; 128:88-94. [PMID: 33205549 DOI: 10.1111/bju.15300] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Revised: 10/06/2020] [Accepted: 11/13/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To build the Wisconsin Stone Quality of Life Machine-Learning Algorithm (WISQOL-MLA) to predict urolithiasis patients' health-related quality of life (HRQoL) based on demographic, symptomatic and clinical data collected for the validation of the Wisconsin Stone Quality-of-Life (WISQOL) questionnaire, an HRQoL measurement tool designed specifically for patients with kidney stones. MATERIAL AND METHODS We used data from 3206 stone patients from 16 centres. We used gradient-boosting and deep-learning models to predict HRQoL scores. We also stratified HRQoL scores by quintile. The dataset was split using a standard 70%/10%/20% training/validation/testing ratio. Regression performance was evaluated using Pearson's correlation. Classification was evaluated with an area under the receiver-operating characteristic curve (AUROC). RESULTS Gradient boosting obtained a test correlation of 0.62. Deep learning obtained a correlation of 0.59. Multivariate regression achieved a correlation of 0.44. Quintile stratification of all patients in the WISQOL dataset obtained an average test AUROC of 0.70 for the five classes. The model performed best in identifying the lowest (0.79) and highest quintiles (0.83) of HRQoL. Feature importance analysis showed that the model weighs in clinically relevant factors to estimate HRQoL, such as symptomatic status, body mass index and age. CONCLUSIONS Harnessing the power of the WISQOL questionnaire, our initial results indicate that the WISQOL-MLA can adequately predict a stone patient's HRQoL from readily available clinical information. The algorithm adequately relies on relevant clinical factors to make its HRQoL predictions. Future improvements to the model are needed for direct clinical applications.
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Affiliation(s)
- David-Dan Nguyen
- Faculty of Medicine, McGill University, Montreal, QC, Canada.,Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Jack W Luo
- Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Xing Han Lu
- School of Computer Science, McGill University, Montreal, QC, Canada
| | - Seth K Bechis
- University of California San Diego School of Medicine, San Diego, CA, USA
| | - Roger L Sur
- University of California San Diego School of Medicine, San Diego, CA, USA
| | - Stephen Y Nakada
- Department of Urology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - Jodi A Antonelli
- University of Texas Southwestern Medical Center, Dallas, TX, USA
| | | | - Sri Sivalingam
- Cleveland Clinic, Glickman Urological and Kidney Institute, Cleveland, OH, USA
| | | | | | - Jaime Landman
- University of California Irvine School of Medicine, Orange, CA, USA
| | - Thomas Chi
- University of California San Francisco School of Medicine, San Francisco, CA, USA
| | - Vernon M Pais
- Dartmouth Hitchcock Medical Center, Lebanon, NH, USA
| | - Ben H Chew
- Department of Urologic Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Vincent G Bird
- University of Florida College of Medicine, Gainesville, FL, USA
| | - Sero Andonian
- McGill University Health Center, Montreal, QC, Canada
| | - Noah E Canvasser
- University of California Davis School of Medicine, Sacramento, CA, USA
| | | | - Kristina L Penniston
- Department of Urology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - Naeem Bhojani
- Division of Urology, Centre Hospitalier de l'Université de Montréal (CHUM), Université de Montréal, Montreal, QC, Canada
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Is Stone-free Status After Surgical Intervention for Kidney Stones Associated With Better Health-related Quality of Life? - A Multicenter Study From the North American Stone Quality of Life Consortium. Urology 2020; 148:77-82. [PMID: 33290774 DOI: 10.1016/j.urology.2020.09.058] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 09/16/2020] [Accepted: 09/21/2020] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To compare the health-related quality of life (HRQOL) of patients with residual fragments after surgical intervention for kidney stones to patients that are stone-free using the disease-specific Wisconsin stone quality of life (WISQOL) questionnaire. Kidney stones contribute to impaired HRQOL, which is increasingly recognized as an important healthcare outcome measurement. MATERIALS AND METHODS With institutional review board approval, 313 adult patients who underwent surgical intervention for kidney stones at 4 sites completed a WISQOL questionnaire. We retrospectively collected surgical data including presence of residual fragments on post-operative imaging. We calculated standardized WISQOL total and domain scores (0-100), which included items related to social functioning (D1), emotional functioning (D2), stone-related impact (D3), and vitality (D4). Scores were compared between patients with residual fragments to those who were stone-free after surgical intervention. RESULTS Demographics did not differ between groups, overall mean age 54.6 ± 13.5 and 55.4% female. There was no significant difference in total WISQOL score for patients with residual fragments (n = 124) compared to patients that were stone-free (n = 189), 110.5 ± 27.8 vs 115.4 ± 23.6 respectively, (P = .12). Interestingly, patients with residual fragments who underwent secondary surgery were found to have significantly lower total WISQOL score (88.4 ± 30.1 vs 116.6 ± 25.0, P <.0001). CONCLUSION Stone-free status after surgical intervention is not associated with better HRQOL when compared with patients whose surgeries left residual fragments. Indeed, further surgical intervention on residual fragments to achieve stone-free status may actually result in worse HRQOL.
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Oh KJ. Risk factors for urinary stone. JOURNAL OF THE KOREAN MEDICAL ASSOCIATION 2020. [DOI: 10.5124/jkma.2020.63.11.660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Urolithiasis is one of the most common urologic diseases in Korea. The annual incidence of urolithiasis in Korea has increased over time. Understanding the epidemiology and risk factors for urolithiasis is essential for patient care and prevention. The purpose of this review was to summarize the recent literature regarding the risk factors for urolithiasis. The available Korean-population-based trials were enrolled in this study. The peak incidence age was the fifth to sixth decades in Korea. There has been a persistent male predominance in the prevalence and incidence of stone disease. The gender gap has continuously narrowed over the world. Climate and seasonal variations, such as temperature and humidity, have a profound effect on the development of urolithiasis. Various dietary factors, including calcium, sodium, animal protein, and oxalate, play an important role in the development of urolithiasis. Dehydration is a wellknown risk factor for stone disease. Many metabolic diseases can affect urolithiasis, including obesity, hypertension, diabetes, gout, and metabolic syndrome. The fast-moving super-aged society and global warming can increase stone disease burden in the near future. To prevent and reduce stone diseases, clinicians should understand the risk factors affecting stone formation.
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Lundeen C, Lim JRZ, Scotland KB, Ardekani RS, Penniston KL, Streeper NM, Chi T, Landman J, Viprakasit DP, Chew BH. What is the relationship of stress to patients' kidney stone-related quality of life? Can Urol Assoc J 2020; 15:E256-E260. [PMID: 33119497 DOI: 10.5489/cuaj.6652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Health-related quality of life (HRQOL) is decreased in patients with kidney stones at all stages of stone disease, even when asymptomatic. Stress is thought to contribute to HRQOL, although there has been minimal investigation into the effect of stress on stone-related quality of life (QOL). We used the Wisconsin Stone Quality of Life Questionnaire (WISQOL) to assess the relationship of stress to stone-related QOL in kidney stone patients. METHODS As part of the WISQOL Research Consortium, patients were approached in outpatient clinics and completed the WISQOL and the Perceived Stress Scale 10-item questionnaire (PSS-10). Patients with stones at enrollment were divided into those with symptoms and those without, while patients with no current stones formed another group. Questionnaire scores from each group were compared statistically and correlations between the groups were calculated. RESULTS Patients (n=704) were enrolled from six centers. The WISQOL successfully discriminated between patients with current stones and those without (p<0.0001), while the PSS-10 did not (p=0.0869). The PSS-10 revealed patients with symptomatic kidney stones experienced higher levels of general stress than asymptomatic subjects (p<0.0001). However, a Pearson correlation test comparing the responses from each instrument revealed no overall correlation between general stress and HRQOL (r=0.05). CONCLUSIONS Symptomatic kidney stones increase general stress, as these patients demonstrate higher PSS-10 scores. Despite this, no correlation exists between general stress and stone-related QOL in patients with stone disease regardless of their stone and symptom status. This implies the existence of other factors impacting QOL in these patients, which warrants further exploration.
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Affiliation(s)
- Colin Lundeen
- Department of Urologic Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Jonathan R Z Lim
- Department of Urologic Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Kymora B Scotland
- Department of Urologic Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Reza Safaee Ardekani
- Department of Urologic Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Kristina L Penniston
- Department of Urology, University of Wisconsin-Madison, Madison, WI, United States
| | | | - Thomas Chi
- Department of Urology, University of California San Francisco, San Francisco, CA, United States
| | - Jaime Landman
- Department of Urology, University of California Irvine, Irvine, CA, United States
| | - Davis P Viprakasit
- Department of Urology, University of North Carolina, Chapel Hill, NC, United States
| | - Ben H Chew
- Department of Urologic Sciences, University of British Columbia, Vancouver, BC, Canada
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Atis G, Culpan M, Ucar T, Sendogan F, Kazan HO, Yildirim A. The effect of shock wave lithotripsy and retrograde intrarenal surgery on health-related quality of life in 10-20 mm renal stones: a prospective randomized pilot study. Urolithiasis 2020; 49:247-253. [PMID: 33074423 DOI: 10.1007/s00240-020-01219-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Accepted: 10/08/2020] [Indexed: 12/23/2022]
Abstract
The effects of treatment modalities such as retrograde intrarenal surgery (RIRS) and shock wave lithotripsy (SWL) on health-related quality of life (HRQoL) were determined in patients with renal stones between 10 and 20 mm. A total of 120 patients were included in the study and prospectively randomized to RIRS or SWL group. A total of 39 patients experienced treatment failure and finally 81 patients (45 patients in the RIRS group, 36 patients in the SWL group) were analyzed for HRQoL. SF-36 survey was used to determine HRQoL pre-operatively, post-operative day 1 and 1 month. The patient and stone characteristics such as age, gender, stone size, grade of hydronephrosis and body mass index were similar between the two groups. At post-operative day 1, the RIRS group was associated with lower scores of role functioning/physical (p = 0.008), role functioning/emotional (p = 0.047) energy/fatigue (p = 0.011), social functioning (p = 0.003) and pain (p = 0.003) when compared to the SWL group. At post-operative 1 month, only pain and emotional well-being scores (p = 0.012 and p = 0.011, respectively) in the RIRS group were statistically lower according to the SWL group. In our study, patients in the SWL group showed more favorable HRQoL scores when compared to the patients in the RIRS group in short-term follow-up.
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Affiliation(s)
- Gokhan Atis
- Department of Urology, Faculty of Medicine, Istanbul Medeniyet University, Eğitim Mah. Dr. Erkin Cad. Kadıköy, 34722, Istanbul, Turkey
| | - Meftun Culpan
- Department of Urology, Faculty of Medicine, Istanbul Medeniyet University, Eğitim Mah. Dr. Erkin Cad. Kadıköy, 34722, Istanbul, Turkey.
| | - Taha Ucar
- Department of Urology, Faculty of Medicine, Istanbul Medeniyet University, Eğitim Mah. Dr. Erkin Cad. Kadıköy, 34722, Istanbul, Turkey
| | - Furkan Sendogan
- Department of Urology, Ardahan State Hospital, Ardahan, Turkey
| | - Huseyin Ozgur Kazan
- Department of Urology, Faculty of Medicine, Istanbul Medeniyet University, Eğitim Mah. Dr. Erkin Cad. Kadıköy, 34722, Istanbul, Turkey
| | - Asif Yildirim
- Department of Urology, Faculty of Medicine, Istanbul Medeniyet University, Eğitim Mah. Dr. Erkin Cad. Kadıköy, 34722, Istanbul, Turkey
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Bhojani N, Moussaoui G, Nguyen DD, Trudel MJ, Topouzian GS, Topouzian NG, Penniston KL, Andonian S. Validation of the French version of the Wisconsin Quality of Life (WISQOL) questionnaire for patients with nephrolithiasis. Can Urol Assoc J 2020; 15:E227-E231. [PMID: 33007174 DOI: 10.5489/cuaj.6552] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
INTRODUCTION The Wisconsin Stone Quality of Life (WISQOL) questionnaire has been recently developed to objectively assess quality of life (QOL) in patients with nephrolithiasis. However, a French version of the questionnaire was lacking. Therefore, the aim of the present study was to develop and validate the French version of this tool. METHODS The French version of the WISQOL (F-WISQOL) was developed in a multistep process involving primary translation, back-translation, and pilot testing among a group of patients (n=12). Nephrolithiasis patients from two tertiary care institutions were recruited into this study and completed the following questionnaires: the medical history form and either the WISQOL or F-WISQOL. Internal consistency was assessed using Cronbach's α, and inter-domain associations were evaluated using Spearman's rank correlation (r). One-way ANOVA was used to compare scores from the two groups (WISQOL and F-WISQOL). RESULTS A total of 210 patients were enrolled in this study: 68 in the WISQOL group and 148 in the F-WISQOL group. Internal consistency was high for all domains in both groups (F-WISQOL: 0.924-0.970; WISQOL: 0.888-0.965). No statistically significant difference was found between the two groups' scores. Inter-domain association, measured by Spearman correlation, was moderate to very strong between all the domains in the F-WISQOL. Values ranged from r=0.676-0.915, with acceptable correlation between D1, D2, and D3, but weaker correlation between D4 (vitality) and the three other domains (r=0.676-0.729). CONCLUSIONS In the present study, the French version of the WISQOL questionnaire was validated at two academic institutions.
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Affiliation(s)
- Naeem Bhojani
- Division of Urology, University of Montreal, Montreal, QC, Canada
| | | | - David-Dan Nguyen
- Division of Urology, University of Montreal, Montreal, QC, Canada
| | - Mei Juan Trudel
- Division of Urology, University of Montreal, Montreal, QC, Canada
| | | | | | | | - Sero Andonian
- Division of Urology, McGill University, Montreal, QC, Canada
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Lim JRZ, Scotland KB, Bechis SK, Sur RL, Nakada SY, Antonelli JA, Streeper NM, Sivalingam S, Viprakasit DP, Averch TD, Landman J, Chi T, Pais VM, Bird VG, Andonian S, Bhojani N, Canvasser NE, Harper JD, Penniston KL, Chew BH. Metabolic Syndrome Negatively Impacts Stone-Specific Quality of Life. J Endourol 2020; 34:1203-1208. [PMID: 32689819 DOI: 10.1089/end.2020.0247] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Purpose: Metabolic syndrome (MetS) is a cluster of metabolic diseases that is linked to atherosclerotic cardiovascular disease. MetS has also been linked to increased nephrolithiasis. However, limited research has been conducted on MetS and its impact on stone-specific health-related quality of life (HRQOL). This study aims to examine the hypothesis that the presence of MetS is associated with decreased HRQOL. Materials and Methods: The Wisconsin Stone Quality of Life Questionnaire, a stone-specific HRQOL questionnaire, was used to survey 3051 patients with kidney stones. Medical history was collected from patients. These data were used to distinguish MetS patients from non-MetS patients. Among patients with current stones, a Wilcoxon rank sum test was used to compare HRQOL scores from MetS patients and non-MetS patients. HRQOL from patients with and without individual MetS components were also compared, and a multivariate analysis was conducted. Results: Statistical comparison between MetS patients (median score 102/140) and non-MetS patients (median score 106/140) demonstrated a lower stone-specific HRQOL in patients with MetS (p = 0.049). Among individual MetS components, patients with diabetes mellitus (DM) or body mass index (BMI) >30 had significantly lower HRQOL than patients without DM or BMI <30 (p = 0.028 and p < 0.001, respectively). The multivariate analysis supported this trend as MetS remained a significant predictor of decreased HRQOL (p = 0.002) after controlling for other variables assessed. Conclusions: This study indicates an association between MetS and a lower stone-specific QOL. This has important implications for stone prevention strategies in patients with MetS. Clinical Trial Registration number: H14-01143.
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Affiliation(s)
- Jonathan R Z Lim
- Department of Urologic Sciences, University of British Columbia, Vancouver, British Columbia, Canada
| | - Kymora B Scotland
- Department of Urologic Sciences, University of British Columbia, Vancouver, British Columbia, Canada
| | - Seth K Bechis
- University of California San Diego School of Medicine, San Diego, California, USA
| | - Roger L Sur
- University of California San Diego School of Medicine, San Diego, California, USA
| | - Stephen Y Nakada
- University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Jodi A Antonelli
- University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Necole M Streeper
- Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
| | - Sri Sivalingam
- Cleveland Clinic, Glickman Urological and Kidney Institute, Cleveland, Ohio, USA
| | - Davis P Viprakasit
- University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - Timothy D Averch
- Palmetto Health USC Medical Group, Columbia, South Carolina, USA
| | - Jaime Landman
- University of California Irvine School of Medicine, Orange, California, USA
| | - Thomas Chi
- University of California San Francisco School of Medicine, San Francisco, California, USA
| | - Vernon M Pais
- Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire, USA
| | - Vincent G Bird
- University of Florida College of Medicine, Gainesville, Florida, USA
| | - Sero Andonian
- McGill University Health Center, Montreal, Quebec, USA
| | | | - Noah E Canvasser
- University of California Davis School of Medicine, Sacramento, California, USA
| | | | - Kristina L Penniston
- University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Ben H Chew
- Department of Urologic Sciences, University of British Columbia, Vancouver, British Columbia, Canada
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Basulto-Martínez M, Olvera-Posada D, Velueta-Martínez IA, Méndez-Probst C, Flores-Tapia JP, Penniston K, Guerrero-Putz MD, Heinze A. Quality of life in patients with kidney stones: translation and validation of the Spanish Wisconsin Stone Quality of Life Questionnaire. Urolithiasis 2020; 48:419-424. [DOI: 10.1007/s00240-020-01192-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 04/24/2020] [Indexed: 11/24/2022]
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Translation and Linguistic Validation of the Korean Version of the Wisconsin Stone Quality of Life Questionnaire. Int Neurourol J 2020; 24:77-83. [PMID: 32252189 PMCID: PMC7136447 DOI: 10.5213/inj.1836238.119] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2018] [Accepted: 08/28/2019] [Indexed: 11/08/2022] Open
Abstract
Purpose Although cure rate and efficacy of treatment for urinary stone disease have been improved, clinicians have been indifferent to the quality of life (QoL) of stone patients in Korea. The objective of this study was to develop a Korean version of Wisconsin questionnaire about quality of life questionnaire (K-WISQOL) of stone patients for use in Korea. Methods Linguistic validation was permitted for translation by its developers. Three bilingual nonspecialists and 11 panels who were actively involved in treating urinary stone patients performed the translation and linguistic validations. A trained interviewer and 5 Korean patients carried out cognitive debriefing. Results Noun words such as “energy” and “responsibilities” were very difficult to translate to Korean. They were substituted by more comprehensive words. After backward translation, translated sentences showed a good agreement with the original WISQOL. During backward translation and the second reconciliation, previously translated Korean version was revised in 5 sentences. In the cognitive debriefing process, all 5 patients thought that these questions explained the patient’s situation well. Most of these respondents answered that explanatory notes of questionnaire were well written and the format of the questionnaire was easy to follow. Conclusions The present study demonstrated that, despite language differences, translation and linguistic validation of the K-WISQOL were successfully performed. This K-WISQOL could be useful tools for treatment plan and patient care.
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Narang GL, Wiener LE, Penniston KL, Antonelli JA, Averch TD, Sivalingam S, Chew BH, Bird VG, Pais VM, Sur RL, Chi T, Streeper NM, Nakada SY, Koch GG, Viprakasit DP. The effect of travel distance on health-related quality of life for patients with nephrolithiasis. Can Urol Assoc J 2019; 14:99-104. [PMID: 31702546 DOI: 10.5489/cuaj.6090] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
INTRODUCTION Urolithiasis causes a significant impact on health-related quality of life (HRQOL). Patients with kidney stones have high levels of stress and anxiety. Symptom resolution often requires treatment. Travel distance is a barrier to care but little is known about its effects on HRQOL. We hypothesize that increased distance to treatment site is associated with decreased HRQOL. METHODS Patients with a history of stones were enrolled at 11 tertiary centers as part of the QOL Stone Consortium of North America. HRQOL data were obtained using the Wisconsin Stone Quality of Life questionnaire (WISQOL). We calculated distance between patient and treatment site using national ZIP codes. We used linear models to evaluate the effect of distance on HRQOL, while also considering demographics data, stones/symptom status, and distance. RESULTS Of the 1676 enrolled patients, 52% were male, 86% non-Latino White, and the mean age was 53 years. Mean distance to treatment site was 63.3 km (range 0-3774), with 74% reporting current stones and 45% current symptoms. WISQOL score and distance were negatively correlated for patients reporting current stones and symptoms (p=0.0010). Linear modelling revealed decreased WISQOL scores for patients with symptoms as distance increased from treatment site (p=0.0001), with a 4.7-point decrease for every 100 km traveled. CONCLUSIONS Stone disease imposes significant burden on patients' HRQOL due to a variety of factors. Patients with active stone symptoms report worse HRQOL with increased distance to their treatment site. Possible etiologies include travel burden, increased disease burden, decreased healthcare use, and delays in care.
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Affiliation(s)
- Gopal L Narang
- University of North Carolina School of Medicine, Chapel Hill, NC, United States
| | - Laura E Wiener
- Department of Biostatistics, University of North Carolina, Chapel Hill, NC, United States
| | - Kristina L Penniston
- University of Wisconsin School of Medicine and Public Health, Madison, WI, United States
| | - Jodi A Antonelli
- University of Texas Southwestern Medical Center, Dallas, TX, United States
| | | | - Sri Sivalingam
- Glickman Urological & Kidney Institute, Cleveland Clinic, Cleveland, OH
| | - Ben H Chew
- University of British Columbia, Vancouver, BC, Canada
| | - Vincent G Bird
- University of Florida College of Medicine, Gainesville, FL, United States
| | - Vernon M Pais
- Geisel School of Medicine at Dartmouth, Hanover, NH, United States
| | - Roger L Sur
- University of California San Diego School of Medicine, San Diego, CA, United States
| | - Thomas Chi
- University of California San Francisco School of Medicine, San Francisco, CA, United States
| | - Necole M Streeper
- Penn State Health Milton S. Hershey Medical Center, Hershey, PA, United States
| | - Stephen Y Nakada
- University of Wisconsin School of Medicine and Public Health, Madison, WI, United States
| | - Gary G Koch
- Department of Biostatistics, University of North Carolina, Chapel Hill, NC, United States
| | - Davis P Viprakasit
- University of North Carolina School of Medicine, Chapel Hill, NC, United States
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Ragab M, Baldin N, Collie J, Tran MG, Al‐Hayek S, S. Parsy K, Armitage J, Wiseman O. Qualitative exploration of the renal stone patients’ experience and development of the renal stone‐specific patient‐reported outcome measure. BJU Int 2019; 125:123-132. [DOI: 10.1111/bju.14873] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- Mostafa Ragab
- Cambridge University Hospitals NHS Foundation Trust CambridgeUK
| | - Nikolay Baldin
- Department of Applied Mathematics and Theoretical Physics University of Cambridge CambridgeUK
| | - Jane Collie
- Cambridge University Hospitals NHS Foundation Trust CambridgeUK
| | | | - Sami Al‐Hayek
- Cambridge University Hospitals NHS Foundation Trust CambridgeUK
| | - Kasra S. Parsy
- Cambridge University Hospitals NHS Foundation Trust CambridgeUK
| | - James Armitage
- Cambridge University Hospitals NHS Foundation Trust CambridgeUK
| | - Oliver Wiseman
- Cambridge University Hospitals NHS Foundation Trust CambridgeUK
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Jung JS, Han CH, Bae S. Study on the prevalence and incidence of urolithiasis in Korea over the last 10 years: An analysis of National Health Insurance Data. Investig Clin Urol 2018; 59:383-391. [PMID: 30402571 PMCID: PMC6215783 DOI: 10.4111/icu.2018.59.6.383] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Accepted: 09/26/2018] [Indexed: 11/18/2022] Open
Abstract
Purpose We aimed to analyze the incidence and prevalence of urolithiasis in Korea over the last decade using the National Health Insurance (NHI) sample cohort data. Materials and Methods From January 2002 to December 2013, we enrolled sample cohort data from the NHI. Patients diagnosed with international classification of diseases code N20 or N13.2 were included. The incidence and prevalence rate was counted from the same period and patients previously diagnosed with urolithiasis were excluded. We compared the incidence and prevalence of urolithiasis by region, age, and sex, and identified the changes. Results Total 1,111,828 subjects were included. Of these subjects, 36,857 had urolithiasis. The male-to-female ratio was 1.57:1, and total incidence rate was 3.27 per 1,000 person-years (1,000p-yrs). The annual incidence was lowest in 2013 (3,138 patients) and highest in 2005 (3,751 patients). Incidence rate by diagnostic code was highest in ureter stone only (2.49 per 1,000p-yrs) and was lowest in kidney and ureter stone both (0.17 per 1,000p-yrs). Prevalence gradually increased from 3,172 in 2002 and 5,758 in 2013. Jeollanam-do had the highest incidence rate of 3.70 persons per 1,000p-yrs, and Jeju had the lowest rate of 2.84 persons per 1,000p-yrs. In gender analysis, Daegu had the highest incidence (4.56) in males, Jeollanam-do had the highest incidence (3.20) in females. Conclusions Annual incidence remained stable, whereas prevalence gradually increased. The incidence in male was 1.57 times higher than female, and the peak incidence age was 45–49 years, with the highest incidence occurring in Jeollanam-do and the lowest in Jeju.
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Affiliation(s)
- Joon Se Jung
- Department of Urology, Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Uijeongbu, Korea
| | - Chang Hee Han
- Department of Urology, Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Uijeongbu, Korea
| | - Sangrak Bae
- Department of Urology, Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Uijeongbu, Korea
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Raffin EP, Penniston KL, Antonelli JA, Viprakasit DP, Averch TD, Bird VG, Chew BH, Sivalingam S, Sur RL, Nakada SY, Pais VM. The Effect of Thiazide and Potassium Citrate Use on the Health Related Quality of Life of Patients with Urolithiasis. J Urol 2018; 200:1290-1294. [PMID: 29913138 DOI: 10.1016/j.juro.2018.06.023] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/10/2018] [Indexed: 10/14/2022]
Abstract
PURPOSE To our knowledge it is unknown whether the benefits of medical management of urolithiasis outweigh the potential side effects of the medications used, including potassium citrate and thiazide diuretics. Therefore, we evaluated the relationship between potassium citrate or thiazides and overall stone related health related quality of life. MATERIALS AND METHODS Cross-sectional data were obtained on stone forming enrollees in the North American Stone Quality of Life Consortium. We used the WISQOL (Wisconsin Stone Quality of Life) questionnaire to compare health related quality of life between patients treated and not treated with potassium citrate or thiazide type diuretics. Additionally, the likelihood of gastrointestinal complaints was compared between those prescribed and not prescribed potassium citrate. The likelihood of fatigue and sexual complaints was also compared in those prescribed and not prescribed thiazides. RESULTS Of the 1,511 subjects, including 787 males and 724 females, 279 were on potassium citrate and 238 were on thiazides at study enrollment. Patients prescribed potassium citrate had higher health related quality of life in each domain vs those not prescribed potassium citrate (p <0.001). Patients prescribed thiazides had higher health related quality of life in each domain compared to those not prescribed thiazide (all p <0.01). Those prescribed potassium citrate were less likely than those not prescribed potassium citrate to report nausea, stomach upset or cramps (OR 0.57, p <0.001). Patients prescribed thiazides were less likely than those not prescribed thiazides to report fatigue (OR 0.63, p = 0.004) or reduced sexual interest and/or activity (OR 0.64, p = 0.005). CONCLUSIONS Among stone formers the use of potassium citrate and thiazides was associated with better health related quality of life across all WISQOL domains without an increased likelihood of gastrointestinal complaints and fatigue or sexual complaints, respectively. These findings may be useful when counseling patients regarding the initiation of potassium citrate or thiazides for medical management of nephrolithiasis.
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Affiliation(s)
- Eric P Raffin
- Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire.
| | - Kristina L Penniston
- University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | | | - Davis P Viprakasit
- University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Timothy D Averch
- University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Vincent G Bird
- University of Florida College of Medicine, Gainesville, Florida
| | - Ben H Chew
- Department of Urologic Sciences, University of British Columbia, Vancouver, British Columbia, Canada
| | - Sri Sivalingam
- Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio
| | - Roger L Sur
- University of California-San Diego School of Medicine, San Diego, California
| | - Stephen Y Nakada
- University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Vernon M Pais
- Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire
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Abstract
BACKGROUND Some centres favour early intervention for ureteral colic while others prefer trial of spontaneous passage, and relative outcomes are poorly described. Calgary and Vancouver have similar populations and physician expertise, but differing approaches to ureteral colic. We studied 60-day hospitalization and intervention rates for patients having a first emergency department (ED) visit for ureteral colic in these diverse systems. METHODS We used administrative data and structured chart review to study all Vancouver and Calgary patients with an index visit for ureteral colic during 2014. Patient demographics, arrival characteristics and triage category were captured from ED information systems, while ED visits and admissions were captured from linked regional hospital databases. Laboratory results were obtained from electronic health records and stone characteristics were abstracted from diagnostic imaging reports. Our primary outcome was hospitalization or urological intervention from 0 to 60 days. Secondary outcomes included ED revisits, readmissions and rescue interventions. Time to event analysis was conducted and Cox Proportional Hazards modelling was performed to adjust for covariate imbalance. RESULTS We studied 3283 patients with CT-defined stones. Patient and stone characteristics were similar for the cities. Hospitalization or intervention occurred in 60.9% of Calgary patients and 31.3% of Vancouver patients (p<0.001). Calgary patients had higher index intervention rates (52.1% v. 7.5%), and experienced more ED revisits and hospital readmissions during follow-up. The data suggest that outcome events were associated with overtreatment of small stones in one city and undertreatment of large stones in the other. CONCLUSIONS An early interventional approach was associated with higher ED revisit, hospitalization and intervention rates. If these events are markers of patient disability, then a less interventional approach to small stones and earlier definitive management of large stones may reduce system utilization and improve outcomes for patients with acute ureteral colic.
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Talwar R, Ziemba J. Validated Methods of Assessing Quality of Life in Stone Disease. Curr Urol Rep 2018; 19:25. [DOI: 10.1007/s11934-018-0776-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Atalay HA, Ülker V, Canat L, Özer M, Can O, Penniston KL. Validation of the Turkish version of the Wisconsin stone-quality of life questionnaire. Turk J Urol 2018; 45:118-123. [PMID: 29799402 DOI: 10.5152/tud.2018.35305] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Accepted: 01/19/2018] [Indexed: 11/22/2022]
Abstract
OBJECTIVE We validated the Turkish version of the Wisconsin Stone-Quality of Life (WISQoL) questionnaire for male and female patients with kidney stones. MATERIAL AND METHODS The Turkish version of the WISQoL questionnaire was developed following a well-established multistep process. A total of 84 patients with kidney stones completed the Turkish WISQoL questionnaire, including the other validated questionnaires as The Short Form Health Survey (SF-36 v2) and Beck's Depression Inventory. Patients completed questionnaires before percutaneous nephrolithotomy (PNL) surgery as well as 2-4 weeks after surgery. Reliability was evaluated by internal consistency (tested by Cronbach's alfa) and test-retest reliability between week 2 and 4 (tested by Spearman correlation). Domain structures were examined by interdomain correlations using Spearman correlation coefficient. Convergent validity was assessed by correlating the scores of general health domain to the SF-36 v2, and the scores of emotional impact domain to the Beck's Depression Inventory questionnaire. Sensitivity to change was assessed by comparing scores before and after PNL surgery with the Wilcoxon signed rank test. Discriminant validity was evaluated by comparing the results of patients 2 and 4 weeks after surgery with Wilcoxon-rank sum tests. RESULTS The Turkish version of the WISQoL demonstrates good internal consistency (Cronbach's α=0.72-0.78) and test-retest reliability (p>0.05). Inter-domain associations within the WISQOL showed a substantial correlation between various WISQoL domains, indicating a high conceptual relationship between the domains. Also, the Turkish version of the WISQoL showed convergent validity with the corresponding validated questionnaires (Spearman's rho correlation coefficient=0.44-0.78). All domains of the WISQoL showed significant sensitivity to change (p≤0.001). CONCLUSION The Turkish version of the WISQoL is a generally reliable instrument that can be self-administered by Turkish patients with kidney stones in clinical and research settings. Further clinical studies in Turkish settings would be useful to provide powerful data on sensitivity to change.
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Affiliation(s)
- Hasan Anıl Atalay
- Department of Urology, Okmeydanı Training and Research Hospital, İstanbul, Turkey
| | - Volkan Ülker
- Department of Urology, İzmir Tepecik Training and Research Hospital, İzmir, Turkey
| | - Lütfi Canat
- Department of Urology, Okmeydanı Training and Research Hospital, İstanbul, Turkey
| | - Murat Özer
- Department of Urology, Okmeydanı Training and Research Hospital, İstanbul, Turkey
| | - Osman Can
- Department of Urology, Okmeydanı Training and Research Hospital, İstanbul, Turkey
| | - Kristina L Penniston
- Department of Urology University of Wisconsin School of Medicine and Public Health, Wisconsin, USA
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Tierney JE, Schlunk SG, Jones R, George M, Karve P, Duddu R, Byram BC, Hsi RS. In vitro feasibility of next generation non-linear beamforming ultrasound methods to characterize and size kidney stones. Urolithiasis 2018; 47:181-188. [PMID: 29356874 DOI: 10.1007/s00240-018-1036-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Accepted: 01/10/2018] [Indexed: 11/24/2022]
Abstract
Ultrasound imaging for kidney stones suffers from poorer sensitivity, diminished specificity, and overestimation of stone size compared to computed tomography (CT). The purpose of this study was to demonstrate in vitro feasibility of novel ultrasound imaging methods comparing traditional B-mode to advanced beamforming techniques including plane wave synthetic focusing (PWSF), short-lag spatial coherence (SLSC) imaging, mid-lag spatial coherence (MLSC) imaging with incoherent compounding, and aperture domain model image reconstruction (ADMIRE). The ultrasound techniques were evaluated using a research-based ultrasound system applied to an in vitro kidney stone model at 4 and 8 cm depths. Stone diameter sizing and stone contrast were compared among the different techniques. Analysis of variance was used to analyze the differences among group means, with p < 0.05 considered significant, and a Student's t test was used to compare each method with B-mode, with p < 0.0025 considered significant. All stones were detectable with each method. MLSC performed best with stone sizing and stone contrast compared to B-mode. On average, B-mode sizing error ± SD was > 1 mm (1.2 ± 1.1 mm), while those for PWSF, ADMIRE, and MLSC were < 1 mm (- 0.3 ± 2.9 mm, 0.6 ± 0.8, 0.8 ± 0.8, respectively). Subjectively, MLSC appeared to suppress the entire background thus highlighting only the stone. The ADMIRE and SLSC techniques appeared to highlight the stone shadow relative to the background. The detection and sizing of stones in vitro are feasible with advanced beamforming methods with ultrasound. Future work will include imaging stones at greater depths and evaluating the performance of these methods in human stone formers.
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Affiliation(s)
- Jaime E Tierney
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA
| | - Siegfried G Schlunk
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA
| | - Rebecca Jones
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA
| | - Mark George
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA
| | - Pranav Karve
- Department of Civil and Environmental Engineering, Vanderbilt University, Nashville, TN, USA
| | - Ravindra Duddu
- Department of Civil and Environmental Engineering, Vanderbilt University, Nashville, TN, USA
| | - Brett C Byram
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA
| | - Ryan S Hsi
- Department of Urologic Surgery, Vanderbilt University Medical Center, A-1302 Medical Center North, Nashville, TN, USA.
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Ellison JS, Williams M, Keeley FX. Patient-Reported Outcomes in Nephrolithiasis: Can We Do Better? J Endourol 2018; 32:10-20. [DOI: 10.1089/end.2017.0241] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Jonathan S. Ellison
- Division of Pediatric Urology, Seattle Children's Hospital, University of Washington, Seattle, Washington
| | - Marc Williams
- Department of Urology, Bristol Urological Institute, Southmead Hospital, Bristol, United Kingdom
| | - Francis X. Keeley
- Department of Urology, Bristol Urological Institute, Southmead Hospital, Bristol, United Kingdom
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Patel N, Brown RD, Sarkissian C, De S, Monga M. Quality of life and urolithiasis: the patient - reported outcomes measurement information system (PROMIS). Int Braz J Urol 2017; 43:880-886. [PMID: 28792186 PMCID: PMC5678519 DOI: 10.1590/s1677-5538.ibju.2016.0649] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2016] [Accepted: 04/24/2017] [Indexed: 11/22/2022] Open
Abstract
Background: With a high rate of recurrence, urolithiasis is a chronic disease that impacts quality of life. The Patient Reported Outcomes Measurement Information System is an NIH validated questionnaire to assess patient quality of life. We evaluated the impact of urolithiasis on quality of life using the NIH-sponsored PROMIS-43 questionnaire. Materials and Methods: Patients reporting to the kidney stone clinic were interviewed to collect information on stone history and demographic information and were asked to complete the PROMIS-43 questionnaire. Quality of life scores were analyzed using gender and age matched groups for the general US population. Statistical comparisons were made based on demographic information and patient stone history. Statistical significance was P<0.05. Results: 103 patients completed the survey. 36% of respondents were male, the average age of the group was 52 years old, with 58% primary income earners, and 35% primary caregivers. 7% had never passed a stone or had a procedure while 17% passed 10 or more stones in their lifetime. Overall, pain and physical function were worse in patients with urolithiasis. Primary income earners had better quality of life while primary caregivers and those with other chronic medical conditions were worse. Patients on dietary and medical therapy had better quality of life scores. Conclusions: Urolithiasis patients subjectively have worse pain and physical function than the general population. The impact of pain on quality of life was greatest in those patients who had more stone episodes, underscoring the importance of preventive measures. Stone prevention measures improve quality of life.
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Affiliation(s)
- Nishant Patel
- Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Robert D Brown
- Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Carl Sarkissian
- Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Shubha De
- Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Manoj Monga
- Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
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Borofsky MS, Lane GI, Neises SM, Portis AJ. Patient-Reported Outcomes Measurement System (PROMIS
®
) for Patients with Urolithiasis: Initial Report. J Urol 2017; 198:1091-1097. [DOI: 10.1016/j.juro.2017.05.080] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/30/2017] [Indexed: 12/12/2022]
Affiliation(s)
- Michael S. Borofsky
- Department of Urology, University of Minnesota, Minneapolis, Minnesota
- HealthEast Kidney Stone Institute, St. Paul, Minnesota
| | - Giulia I. Lane
- Department of Urology, University of Minnesota, Minneapolis, Minnesota
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40
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Jiang H, Huang D, Yao S, Liu S. Improving Drainage After Percutaneous Nephrolithotomy Based on Health-Related Quality of Life: A Prospective Randomized Study. J Endourol 2017; 31:1131-1138. [PMID: 28891320 DOI: 10.1089/end.2017.0444] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
PURPOSE The impact of drainage type after percutaneous nephrolithotomy (PCNL) on the health-related quality of life (HRQoL) has been rarely studied. We conducted a prospective randomized study to evaluate the differences in HRQoL among patients who received different drainage types. METHODS A total of 90 patients who underwent PCNL were randomized into three groups to receive a nephrostomy tube (Group 1), a Double-J (JJ) stent (Group 2), and an open-ended ureteral catheter (Group 3) after PCNL, respectively. We compared the perioperative characteristics, surgical outcomes, and HRQoL using Wisconsin Stone Quality of Life (WiSQoL) questionnaire among three groups. RESULTS There were no significant differences in patients' characteristics such as age, gender ratio, body mass index, stone burden, and so on. Majority of the surgical outcomes (operative time, estimated blood loss, hemoglobin drop, postoperative complications, and stone-free rate) were also comparable, except for the duration of hospitalization, visual analog scale, and analgesic required. The preoperative WiSQoL scores were similar among the three groups, but significant differences occurred postoperation (Groups 1, 2, and 3, 122.0 vs 105.6 vs 124.4, p < 0.001). Besides, patients in Group 2 had lower willingness (Groups 1, 2, and 3, 86.7% vs 70.0% vs 96.7%, p = 0.02) to undergo the same procedure as future treatment, if needed. CONCLUSIONS Our study suggested that the drainage types after PCNL using a nephrostomy tube or a JJ stent or an open-ended ureteral catheter were equally safe and efficacious, but patients who received a nephrostomy tube or an open-ended ureteral catheter had better HRQoL.
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Affiliation(s)
- Huiming Jiang
- 1 Department of Urology, Meizhou People's Hospital (Huangtang Hospital), Meizhou Hospital Affiliated to Sun Yat-sen University, Meizhou, China
| | - Diandong Huang
- 1 Department of Urology, Meizhou People's Hospital (Huangtang Hospital), Meizhou Hospital Affiliated to Sun Yat-sen University, Meizhou, China
| | - Shiwu Yao
- 1 Department of Urology, Meizhou People's Hospital (Huangtang Hospital), Meizhou Hospital Affiliated to Sun Yat-sen University, Meizhou, China
| | - Siping Liu
- 1 Department of Urology, Meizhou People's Hospital (Huangtang Hospital), Meizhou Hospital Affiliated to Sun Yat-sen University, Meizhou, China
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41
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Penniston KL, Antonelli JA, Viprakasit DP, Averch TD, Sivalingam S, Sur RL, Pais VM, Chew BH, Bird VG, Nakada SY. Validation and Reliability of the Wisconsin Stone Quality of Life Questionnaire. J Urol 2017; 197:1280-1288. [DOI: 10.1016/j.juro.2016.11.097] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/15/2016] [Indexed: 11/26/2022]
Affiliation(s)
| | | | - Davis P. Viprakasit
- University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | | | - Sri Sivalingam
- Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio
| | - Roger L. Sur
- University of California San Diego School of Medicine, San Diego, California
| | - Vernon M. Pais
- Geisel School of Medicine at Dartmouth, Hanover, New Hampshire
| | - Ben H. Chew
- Department of Urologic Sciences, University of British Columbia, Vancouver, British Columbia, Canada
| | - Vincent G. Bird
- University of Florida College of Medicine, Gainesville, Florida
| | - Stephen Y. Nakada
- University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
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42
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Streeper NM, Wertheim ML, Nakada SY, Penniston KL. Cystine Stone Formers Have Impaired Health-Related Quality of Life Compared with Noncystine Stone Formers: A Case-Referent Study Piloting the Wisconsin Stone Quality of Life Questionnaire Among Patients with Cystine Stones. J Endourol 2017; 31:S48-S53. [DOI: 10.1089/end.2016.0564] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Necole M. Streeper
- Department of Urology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Margaret L. Wertheim
- Department of Urology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Stephen Y. Nakada
- Department of Urology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Kristina L. Penniston
- Department of Urology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
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43
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New F, Somani BK. A Complete World Literature Review of Quality of Life (QOL) in Patients with Kidney Stone Disease (KSD). Curr Urol Rep 2016; 17:88. [PMID: 27771854 PMCID: PMC5075340 DOI: 10.1007/s11934-016-0647-6] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Purpose of Review The purpose of this study was to review the current evidence for quality of life (QOL) in patients with kidney stone disease (KSD). Recent Findings A review of literature from inception to May 2016 for all prospective English language articles on QOL in patients with KSD was done. QOL studies post urological procedures or ureteric stents were excluded. Nine studies (1570 patients) were included of which most (n = 6) used the SF-36 QOL tool. Overall, seven of the nine studies demonstrated a lower QOL in patients with KSD. Bodily pain and general health were significantly lower in patients with KSD compared to their control groups. Summary Patients with KSD have an overall lower QOL with most impact on bodily pain and general health domains. Compared to the scale of patients suffering from KSD, more work needs to be done in measuring QOL both in terms of ‘Stone specific’ QOL measuring tools and the quality/number of studies in this field.
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Affiliation(s)
- Francesca New
- Department of Urology, University Hospital Southampton NHS Trust, Southampton, SO16 6YD, UK
| | - Bhaskar K Somani
- Department of Urology, University Hospital Southampton NHS Trust, Southampton, SO16 6YD, UK.
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Raja A, Hekmati Z, Joshi HB. How Do Urinary Calculi Influence Health-Related Quality of Life and Patient Treatment Preference: A Systematic Review. J Endourol 2016; 30:727-43. [DOI: 10.1089/end.2016.0110] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Affiliation(s)
- Aditya Raja
- Cardiff University, Cardiff, United Kingdom
- Department of Urology, University Hospital of Wales, Cardiff, United Kingdom
| | | | - Hrishi B. Joshi
- Department of Urology, University Hospital of Wales, Cardiff, United Kingdom
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45
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Penniston KL, Sninsky BC, Nakada SY. Preliminary Evidence of Decreased Disease-Specific Health-Related Quality of Life in Asymptomatic Stone Patients. J Endourol 2016; 30 Suppl 1:S42-5. [DOI: 10.1089/end.2016.0074] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Kristina L. Penniston
- Department of Urology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Brian C. Sninsky
- Department of Urology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Stephen Y. Nakada
- Department of Urology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
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Abstract
Kidney stones are mineral deposits in the renal calyces and pelvis that are found free or attached to the renal papillae. They contain crystalline and organic components and are formed when the urine becomes supersaturated with respect to a mineral. Calcium oxalate is the main constituent of most stones, many of which form on a foundation of calcium phosphate called Randall's plaques, which are present on the renal papillary surface. Stone formation is highly prevalent, with rates of up to 14.8% and increasing, and a recurrence rate of up to 50% within the first 5 years of the initial stone episode. Obesity, diabetes, hypertension and metabolic syndrome are considered risk factors for stone formation, which, in turn, can lead to hypertension, chronic kidney disease and end-stage renal disease. Management of symptomatic kidney stones has evolved from open surgical lithotomy to minimally invasive endourological treatments leading to a reduction in patient morbidity, improved stone-free rates and better quality of life. Prevention of recurrence requires behavioural and nutritional interventions, as well as pharmacological treatments that are specific for the type of stone. There is a great need for recurrence prevention that requires a better understanding of the mechanisms involved in stone formation to facilitate the development of more-effective drugs.
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48
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Parr JM, Desai D, Winkle D. Natural history and quality of life in patients with cystine urolithiasis: a single centre study. BJU Int 2015. [DOI: 10.1111/bju.13169] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Justin M. Parr
- School of Medicine; The University of Queensland; Brisbane Queensland Australia
| | - Devang Desai
- School of Medicine; The University of Queensland; Brisbane Queensland Australia
- Department of Urology; Mater Hospital Brisbane; Brisbane Queensland Australia
| | - David Winkle
- School of Medicine; The University of Queensland; Brisbane Queensland Australia
- Department of Urology; Mater Hospital Brisbane; Brisbane Queensland Australia
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49
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Pérez-Fentes DA, Gude F, Blanco B, Freire CG. Percutaneous Nephrolithotomy: Short- and Long-Term Effects on Health-Related Quality of Life. J Endourol 2015; 29:13-7. [DOI: 10.1089/end.2014.0081] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Daniel Adolfo Pérez-Fentes
- Department of Urology, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain
| | - Francisco Gude
- Epidemiology Unit, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain
| | - Benito Blanco
- Department of Urology, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain
| | - Camilo García Freire
- Department of Urology, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain
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50
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Kang HW, Seo SP, Kim WT, Kim YJ, Yun SJ, Lee SC, Kim WJ. Effect of renal insufficiency on stone recurrence in patients with urolithiasis. J Korean Med Sci 2014; 29:1132-7. [PMID: 25120325 PMCID: PMC4129207 DOI: 10.3346/jkms.2014.29.8.1132] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2014] [Accepted: 05/07/2014] [Indexed: 11/20/2022] Open
Abstract
The study was designed to assess the relationship between glomerular filtration rate (GFR) and urinary stone-forming constituents, and to assess the effect of renal insufficiency on stone recurrence risk in first stone formers (SF). Baseline serum creatinine levels were obtained, and renal insufficiency was defined as creatinine clearance ≤60 mL/min (Cockroft-Gault). This retrospective case-control study consists of 342 first SF; 171 SF with normal renal function were selected with 1:1 propensity scores matched to 171 SF with renal insufficiency. Urinary metabolic evaluation was compared to renal function. GFR was positively correlated with urinary calcium, uric acid, and citrate excretion. Subjects with renal insufficiency had significantly lower urinary calcium, uric acid, and citrate excretion than those with normal renal function, but not urine volume. With regard to urinary metabolic abnormalities, similar results were obtained. SF with renal insufficiency had lower calcium oxalate supersaturation indexes and stone recurrence rates than SF with normal renal function. Kaplan-Meier curves showed similar results. In conclusion, GFR correlates positively with urinary excretion of stone-forming constituents in SF. This finding implies that renal insufficiency is not a risk factor for stone recurrence.
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Affiliation(s)
- Ho Won Kang
- Department of Urology, College of Medicine, Chungbuk National University, Cheongju, Korea
| | - Sung Phil Seo
- Department of Urology, College of Medicine, Chungbuk National University, Cheongju, Korea
| | - Won Tae Kim
- Department of Urology, College of Medicine, Chungbuk National University, Cheongju, Korea
| | - Yong-June Kim
- Department of Urology, College of Medicine, Chungbuk National University, Cheongju, Korea
| | - Seok-Joong Yun
- Department of Urology, College of Medicine, Chungbuk National University, Cheongju, Korea
| | - Sang-Cheol Lee
- Department of Urology, College of Medicine, Chungbuk National University, Cheongju, Korea
| | - Wun-Jae Kim
- Department of Urology, College of Medicine, Chungbuk National University, Cheongju, Korea
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