Patient's perception of kidney stone prevention within the emergency department and its adherence factors: a single institution study

Knowledge, attitudes, and practices towards urinary system stones among the Chengdu population

This cross-sectional study aimed to explore the knowledge, attitudes, and practices (KAP) regarding urinary system stones among the general public in Chengdu, China. Conducted between January and June 2023, this research targeted individuals undergoing physical examinations at the Health Management Center of Sichuan Provincial People's Hospital. Structured questionnaires were administered to collect demographic information and assess KAP related to urinary system stones. Following meticulous scrutiny, 1014 valid questionnaires were retained for analysis. The computed scores for knowledge, attitude, and practice were 9.36 ± 4.23 (possible score range 0-17), 37.75 ± 7.20 (possible score range 11-55), and 30.77 ± 4.00 (possible score range 10-50), respectively. These outcomes suggested insufficient knowledge and moderately positive attitudes and practices among the participants. Structural Equation Modeling (SEM) analysis revealed a direct impact of knowledge on attitude (β = 0.967, P < 0.001), with attitude subsequently exerting a direct influence on practice (β = 0.167, P < 0.001). This indicated an indirect impact of knowledge on practice. Additionally, there was a direct effect of knowledge on practice (β = 0.167, P < 0.001). In conclusion, the general populace in Chengdu exhibited insufficient knowledge and moderate attitudes and practices concerning urinary stones. These findings underscore the imperative for targeted educational interventions aimed at enhancing public awareness and fostering positive attitudes and practices toward urinary stone prevention and management.

Gaps in kidney stone disease management: From clinical theory to patient reality

With nephrolithiasis projected to affect 25% of the global population in the next three decades, there is an urgent call for innovative management strategies to prevent and reduce stone recurrence. This study aims to explore the evolving management needs in nephrolithiasis from both patient and healthcare provider perspectives. An expert-collaborative online survey comprising 10 targeted questions on kidney stone management was developed and disseminated. This survey was designed to gather comprehensive insights from patients, physicians and dietician and other person in the field of nephrolithiasis. Analysis of responses from 120 participants, including 45 nephrologists, 38 dieticians, 11 urologists, and 14 kidney stones patients followed in our hospital, revealed critical insights. A significant 97.5% emphasized the necessity of optimizing daily water intake, and 94.1% recognized the need for practical dietary modifications. Additionally, 88.3% of respondents found timely hydration reminders beneficial. Notably, monitoring urine color and pH was valued by 85% and 84.3% of the participants, respectively. A striking disparity emerged in the perception of fatigue and wellness monitoring, with 65% of patients prioritizing fatigue monitoring, a view less shared by healthcare professionals. Similarly, 71% of patients deemed wellness monitoring essential, highlighting a gap in understanding between patients and their caregivers. This study underscores the critical need for more tailored guidance on hydration strategies and the promise of remote urine parameters monitoring in nephrolithiasis management. The findings strongly advocate for a patient-centered approach, aligning medical recommendations with patient lifestyles and experiences, to enhance the effectiveness of nephrolithiasis management.

Development of the self-management scale for urolithiasis patients with indwelling double-J tube

PURPOSE

To develop a specific self-management scale applicable to patients with indwelling double-J tube in urolithiasis, and to test its reliability and validity.

METHODS

The construction and validation of our scale involved three stages. First, an initial version of the questionnaire was formed through literature analysis, group discussions, semi-structured interviews, and the Delphi method. Second, a pre-survey was conducted with 20 urolithiasis patients with indwelling double-J stent placement to test their understanding of the initial questionnaire items and its acceptability. Finally, a formal survey of 234 patients with indwelling double-J tube for urolithiasis was conducted, and the scale was tested for reliability and validity.

RESULTS

After the three stages, a specific self-management scale for urolithiasis patients with indwelling double-J tube was developed, consisting of 30 items across five dimensions with a cumulative contribution rate of 52.541%. The content validity index for item level ranged from 0.8 to 1, and the content validity index for the questionnaire level was 0.93. The correlation between each item and its dimension was > 0.4. The Cronbach's alpha coefficient for the overall questionnaire was 0.910, and the Cronbach's alpha coefficients for each dimension ranged from 0.672 to 0.865. The split-half reliability of the overall questionnaire was 0.864, and the split-half reliabilities for each dimension ranged from 0.659 to 0.827. The test-retest reliability of the overall questionnaire was 0.840, and the test-retest reliabilities for each dimension ranged from 0.674 to 0.818.

CONCLUSION

The specific self-management scale for urolithiasis patients with indwelling double-J tube has good reliability and validity, and it is a reliable and effective tool for evaluating and assessing the self-management level of patients with indwelling double-J tube in urolithiasis.

Investigation of the link between the type and concentrations of heavy metals and other elements in blood and urinary stones and their association to the environmental factors and dietary pattern

BACKGROUND

Kidney and urinary tract stones are among the most common and important health problems, the prevalence of which is increasing nowadays due to a sedentary lifestyle, improper nutrition, destructive habits in fluid consumption, and improper use of medications. One of the causing factors in the formation of urinary stones is heavy metals. These metals present in tiny amounts in the environment and enter the nature and food cycle due to industrial activities and practices that are not compliant with environmental laws.

METHODS

In this context, the present case-control study was conducted to determine the concentrations of heavy metals and other urinary stone-forming elements in both blood and urinary stones and investigate their relationship with environmental factors and dietary patterns in people with urinary stones in Ardabil city in 2022. The sampling of blood and urinary stones was done randomly from patients with urinary stones who were admitted to the Urology Clinic of Imam Reza Hospital, Ardabil. ICP-MS was used to measure the concentrations of heavy metals in the samples. The obtained data were analysed by chi-square test, ANOVA test, t-test, and Tukey test.

RESULTS

The body mass index (BMI) was 27.39 ± 3.72 in the case group and 26.37 ± 2.95 in the control group. The copper and selenium concentrations in blood and urinary stones were higher than in other metals. There was a significant relationship between the history of kidney stones and the probability of developing kidney stones. Moreover, a meaningful relationship was found between the concentration of lead element and the formation of kidney stones. The results showed a significant difference in the concentration of nickel and copper in people who consumed vegetables on a daily basis with those with different types of kidney stones.

CONCLUSION

The comparison amongst the concentration of heavy metals in various kinds of urinary stones showed that the amount of lead metal was higher in calcium phosphate stones than in calcium oxalate stones.

Stone diet and dietary change: understanding determinants for dietary change behaviour in patients following urinary stones

BACKGROUND

Dietary habit is one of the most important methods to prevent and treat urinary stones. However, only limited evidence of the experiences of dietary management among urinary stone patients in Malaysia is available. This study aimed to explore participants' current dietary practices after the diagnosis of urinary stones and to identify the factors that facilitate their dietary changes.

METHODS

A qualitative study with purposive sampling was conducted using face-to-face semistructured interviews. A total of 20 participants from a tertiary general hospital in Kuantan, Malaysia, were recruited in this study. Data were analysed using framework analysis.

RESULTS

Two themes emerged from the analysis. The first theme explained the changes in the dietary practice of the participants postdiagnosis. The second theme revealed that the participants' dietary changes were greatly influenced by personal factors and external support from professionals, family and peers.

CONCLUSIONS

Urinary stone patients highlighted the fear of complications, self-determination and knowledge of nutrition as the main drivers of their dietary change postdiagnosis. Emphasising proper nutritional care by assessing and evaluating dietary self-management among patients can facilitate effective self-care in stone prevention management.

Urolithiasis Symptoms and Risk Factors Among the General Population of Alahsa, Saudi Arabia

OBJECTIVE

This study aims to assess the awareness and attitudes about urolithiasis among the general population of Alahsa, Saudi Arabia.

METHODOLOGY

A cross-sectional study was conducted in September 2022 in Alahsa, Saudi Arabia, using a validated questionnaire that was distributed to the general population. Inclusion criteria include male and female citizens of Saudi Arabia who were living in Alahsa, older than 18 years old, and willing to participate in the study. Exclusion criteria include non-Saudi citizens or Saudi citizens who did not live in Alahsa. Data were analyzed using SPSS Statistics.

RESULT

The results showed there were 1023 participants. The results showed the awareness level of symptoms associated with kidney stones at 29%, complications at 34%, diagnosis at 51%, and treatment at 16%. The results showed there was a significant association between a history of kidney stones and having no complications (p-value = 0.002) or inflammation (p-value = 0.009). However, there was no significant association between kidney stone symptoms and the participants' comorbidities.

CONCLUSION

According to our findings, there was a low level of knowledge about the condition and the methods to prevent it, like dietary and lifestyle modifications. Regardless of the low level of general knowledge, there was some awareness of urolithiasis in some elements. Therefore, it is advised to increase health awareness campaigns.

Perception of Dietary Influences on Renal Stone Formation Among the General Population

Introduction

Urolithiasis is a common disorder worldwide with an increasing prevalence and high recurrence rate. This makes preventive measures like dietary modification an essential part of patient care. This study focuses on gauging the perception of dietary habits favoring kidney stone formation.

Materials and methods

A cross-sectional questionnaire-based study was conducted at Aga Khan University, Karachi, Pakistan. For nine food items and 14 beverages, respondents chose one of four options with regards to their relationship with stone formation, i.e. “increasing”, “decreasing”, “no effect”, and “do not know”. Responses were matched against evidence from the literature to generate correct and incorrect responses, thereby gauging perception for individual items. 

Results

Seven hundred and three participants including 69 (9.6%) with a prior history of kidney stones, were recruited for the study. Participants with a personal history of kidney stone disease were older (odds ratio {OR}: 1.042 CI 1.020-1.064) with a significantly higher family history of stones (OR: 2.151 CI: 1.472-3.144). The majority were managed medically (87%) but never received dietary counseling (57%). Water, soft drinks, and tomatoes were the only three items out of 23 that were correctly identified by >50% of the participants with regards to their effect on stone formation. Responses did not differ significantly between those with stone disease and those without.

Conclusion

There is a lack of awareness among the general population, including individuals with a prior history of kidney stones regarding dietary prevention of kidney stone disease. This demonstrates a lack of existing dietary counseling thus necessitating the need for incorporating it at a mass level.

Social Determinants of Kidney Stone Disease: The Impact of Race, Income and Access on Urolithiasis Treatment and Outcomes

The medical and surgical management of kidney stones is one of the most common functions of the urologist. Management choices are often nuanced, involving the decision to embark on one surgical plan among several options. As the wider medical community critically evaluates the care we provide to an increasingly diverse population, it will be important to examine patient outcomes with a particular focus on ensuring equitable care. This review examines the influence of social parameters on the care of kidney stone patients. The dearth of literature in this area warrants rigorous studies on the relationship between race as well as socioeconomic status and the management of kidney stone disease.

Should we support prophylactic intervention for asymptomatic kidney stones? A retrospective cohort study with long-term follow-up

The purpose of this study was to evaluate the long-term outcomes of patients undergoing prophylactic intervention or active surveillance for asymptomatic kidney stones and identify factors influencing the outcomes. In this retrospective cohort study, we reviewed the medical records of patients with asymptomatic kidney stones in two institutes between November 2014 and November 2019. Standardized questions were asked via phone calls to supplement the outcomes. Pain, hydronephrosis, stone growth, serious infection, gross hematuria, and spontaneous passage were defined as stone-related events. Future intervention was also recorded to evaluate management. A total of 101 patients with 120 kidney units were enrolled in this study. The median follow-up time was 63 months. The patients were classified into the control group (79 cases) or exposure group (41 cases) according to whether they underwent prophylactic intervention before any stone-related events. Generally, the rates of stone-related events and future intervention were significantly different between the two groups (57.0 vs. 12.2%, p < 0.001; and 31.6 vs. 4.9%, p = 0.002, respectively). After applying stabilized inverse probability of treatment weighted, Cox regression suggested that patients who underwent prophylactic intervention were less likely to experience stone-related events and future intervention (HR = 0.175, and HR = 0.028, respectively). In conclusion, patients who underwent prophylactic intervention had a lower risk of stone-related events and future intervention, although they had some slight complications.

Knowledge, awareness and dietary practice on urolithiasis among general population in Kuantan, Pahang, Malaysia: Preliminary findings

Background: To date, no studies have been published at evaluating the level of knowledge, awareness and practice of dietary, particularly regarding to urolithiasis in patients or the general population. This study aims to provide basic information on the level of knowledge, awareness and dietary practice among general population in Kuantan, Pahang.

Design and Methods: The respondents (n=30) were conveniently recruited within 10 kilometers radius of Kuantan city. The data were obtained using semi-guided administered questionnaires, which consists of four parts: socio-demographic data, lifestyle and clinical history (Part A); attitude and awareness on dietary practice regarding urolithiasis (Part B); food frequency questionnaire on urolithiasis (Part C) and level of knowledge on urolithiasis (Part D).

Results: Majority of the respondents were women (70%), Malay (83.3%), mean age of 33.97 (±9.27), married (63.3%), completed higher education level (60%), working with government sector (33.3%) and have fixed monthly income (53.3%). Some of them had hypertension (n=4), diabetes (n=1), gout (n=1) and intestinal problem (n=1). Majority (80%) claimed having no family history of urolithiasis, consumed alcohol (10%), exercise with average frequency 2-3 times/week (46.7%) and heard about urolithiasis from healthcare worker (46.7%). The respondents’ awareness about urolithiasis is considered to be good [81.23 (±9.98)] but having poor knowledge score [2.70 (±1.149)]. Majority preferred whole meal bread, white rice, chicken meat, mackerel fish, chicken egg, apple, carrot, mustard leave and fresh milk in daily intake. Lesser plain water intake than standard requirement was noticed among respondents. Seasoning powder was commonly used for seasoning.

Conclusions: Generally, the general population of Kuantan, Pahang was aware of urolithiasis disease but needed more information on dietary aspect in terms of knowledge and food choice.