Category: Epidemiology, Health Policy, Socioeconomics & Outcomes
Introduction & Objective :
Kidney stone formers have lower health-related quality of life (HRQOL) than non-stone formers. The Wisconsin Stone Quality of Life questionnaire (WISQOL) is a validated survey evaluating the HRQOL of stone formers. The North American Stone Quality of Life Consortium is a multi-center, longitudinal prospective study of kidney stone patients′ HRQOL using the WISQOL, with data currently collected on 2052 patients from 11 centers across North America. This study is a sub-analysis of cross-sectional data looking at the association between age, gender, and race on the HRQOL of stone formers. Awareness of the variable psychological impact of urolithiasis on different populations can help customize future surgical and medical counseling.
Methods : 1778 patients were included in the analysis. Proportional odds model with both univariate and multivariate analysis was used to determine the impact of age, gender, and race on HRQOL. Both total score and scores within 4 sub-domains were included: social functioning, emotional functioning, stonerelatedimpact, and vitality.
Results : Mean total score (standardized to scale of 0-100) for all patients was 70.6 ± 12.7. On both the univariate and multivariate analyses, older patients had a significantly higher total score for HRQOL than younger patients (OR 1.34 and 1.21, respectively, with p-value <0.0001). The total score was higher by 4 points for every decade of age. This finding was consistent throughout all 4 sub-domains on univariate analysis. Male patients had higher HRQOL scores than females on both univariate and multivariate analyses (p-value <0.0001), scoring 5 points above female patients. Again, these findings were significant throughoutall 4 sub-domains on univariate analysis. The effect of race on HRQOL was variable and inconclusive likely due to the small sample size of non-Caucasian patients (15.8%).
Older kidney stone patients and male kidney stone patients have higher stone-related HRQOL than younger patients and females. The clinical impact of these findings might include future implications for patient counseling, including dietary and medical management of stone disease, and potential changes to the paradigm of the surgical management of stones.
Karen Stern– Clinical Fellow, Cleveland Clinic Foundation, Cleveland, Ohio
Jodi Antonelli– Assistant professor urology, UT Southwestern, Dallas, Texas
Davis Viprakasit– Associate Professor of Urology, University of North Carolina, Chapel Hill, North Carolina
Timothy Averch– Chief, Division of Urology, Palmetto Health - University of South Carolina, University of South Carolina, Columbia, South Carolina
Thomas Chi– Associate Professor, UCSF, San Fransisco, California
Ben Chew– Associate Professor, Department of Urologic Sciences, University of British Columbia, Vancouver, British Columbia, Canada
Vincent Bird– Professor of Urology, University of Florida College of Medicine, Department of Urology, Gainseville, Florida
Vernon Pais– Associate Professor, Associate Program Director, Dartmouth, Lebanon, New Hampshire
Necole Streeper– Assistant Professor of Surgery , Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania
Roger Sur– Professor of Urology, UC San Diego Department of Urology, San Diego, California
Stephen Nakada– Professor, University of Wisconsin School of Medicine and Public Health, Department of Urology, Madison, Wisconsin
Kristina Penniston– Senior Scientist, University of Wisconsin School of Medicine and Public Health, Department of Urology, Madison, Wisconsin
Sri Sivalingam– Staff Urologist, Cleveland Clinic Foundation, Cleveland, Ohio
Cleveland Clinic Foundation
Karen Stern MD is currently an Advanced Endourology and Stone Disease Fellow at the Glickman Urological & Kidney Institute of the Cleveland Clinic. She received her BA from Emory University, her medical degree from the University of Arizona and completed her Urology residency at the Mayo Clinic in Phoenix, Arizona. She previously served as the Resident Representative for the Western Section of the AUA and as the Chair of the Residents and Fellows Committee (RFC). She is currently the RFC Representative on the AUA Young Urologists Committee. She is a Mayo Clinic Scholar and will be returning to Mayo Clinic Arizona as a Senior Associate Consultant in July 2019.
Assistant professor urology
Jodi Antonelli, M.D. is an Assistant Professor in the Department of Urology at UT Southwestern Medical Center. She specializes in the medical and surgical management of kidney stone disease.
Dr. Antonelli earned her medical degree from Jefferson Medical College of Thomas Jefferson University. She completed a general surgery internship and a urology residency at Duke University Medical Center. She completed a fellowship in endourology and stone disease in the Department of Urology at UT Southwestern.
Her research interests include evaluation of dietary and medical therapies for kidney stone prevention, assessment of outcomes for minimally invasive surgical treatments, and development and assessment of surgical innovation. She was the recipient of the 2014 Elisabeth Pickett Research Award for the Society of Women in Urology.
Dr. Antonelli is a member of the American Urological Association, the Endourological Society, and ROCK Society.
Associate Professor of Urology
University of North Carolina
Chapel Hill, North Carolina
Chief, Division of Urology
Palmetto Health - University of South Carolina
University of South Carolina
Columbia, South Carolina
San Fransisco, California
Thomas Chi, MD
Associate Chair for Clinical Affairs
Kutzmann Endowed Professor for Clinical Urology
UCSF Department of Urology
Dr. Thomas Chi, MD, graduated as a President's Scholar from Stanford University with a BA in Human Biology and MAs in Sociology and Music. He earned his MD from the University of California, San Francisco where he also completed urology residency and a fellowship in Endourology and Laparoscopy under the mentorship of Dr. Marshall L. Stoller.
During his fellowship, Dr. Chi was awarded grant funding from the National Institutes of Health and the American Urological Association Urology Care Foundation to research the fundamental mechanisms underlying the formation of urinary stones.
He joined the UCSF faculty of the Department of Urology in 2013 where his clinical interests include the care of patients with urinary stone disease and those in need of minimally invasive surgery. He specializes in the performance of endoscopic, laparoscopic, and percutaneous surgeries as well as HoLEP. He has established ReSKU, the Registry for Stones of the Kidneys and Ureter, the first kidney stone registry of its kind for tracking patient clinical outcomes and is an internationally recognized specialist in the use of ultrasound in the management of kidney stones to minimize patient radiation exposure.
In addition to his clinical interests, Dr. Chi supervises an NIH-funded translational science lab where he leads a cross-disciplinary research team. His research focuses on understanding the genetic and microbial environment of the kidney related to how kidney stones form and developing new medical preventative interventions. He has developed a novel model fruit fly for the study of kidney stones and has published over 80 peer-reviewed articles and book chapters spanning both basic science as well as epidemiologic approaches centered around improving the care of patients with urinary stone disease.
Associate Professor, Department of Urologic Sciences
University of British Columbia
Vancouver, British Columbia, Canada
Dr. Chew is a urologist and the Director of Clinical Research at the Stone Centre at Vancouver General Hospital and an Associate Professor of Urology at the University of British Columbia in Vancouver, Canada. His main interests lie in the treatment and research of the pathophysiology of kidney stone disease. His research focus includes metabolic stone disease as well as biomaterials used in the urinary tract for ureteral stents. He has worked on various stent designs, stent coatings and drug-eluting ureteral stents to try and improve the quality of life for patients with kidney stone disease. He continues work on a degradable ureteral stent and has completed the first-in-human trials. Current studies include attempting to understand second messenger systems that are activated within the kidney and ureter once a ureteral stent has been placed. These could be exploited as future therapeutic targets for new drug eluting ureteral stents or designs to reduce symptoms.
He has authored over 80 peer-reviewed manuscripts and book chapters. He is a member of the Endourologic Disease Group for Excellence (EDGE) research consortium (www.endoedge.net) and the Wisconsin Quality of Life (WISQoL) research consortium. Dr. Ben Chew is also the Chair of Research for the Endourology Society. The role of the Research Chair is to facilitate and help improve research for the entire society.
Professor of Urology
University of Florida College of Medicine, Department of Urology
Dr. Vincent G. Bird is currently Professor in the Department of Urology, Chief of the Division of Minimally Invasive Surgery, the endourology and minimally invasive surgery fellowship program co-director, and associate program director of the residency program in the Department of Urology at the University of Florida College of Medicine. Dr. Bird completed his fellowship training in robotics, laparoscopy and endourology at the University of Iowa Hospitals and Clinics. At the conclusion of his fellowship, Dr. Bird was recognized for excellence in clinical science by the Endourological Society for research relating to patterns of treatment for urinary stone disease.
Dr. Bird received his undergraduate education at Boston University, and attended medical school at the State University of New York, Stony Brook, where he received his medical degree with distinction in research and was also awarded for his work involving cellular processes related to cancer and inflammation. Dr. Bird then completed his general surgical and urological training at the University of Miami. Currently, his clinical practice focuses on renal surgery for urinary stone disease, renal obstruction, and renal cancer, while his clinical and basic science research focus is on the treatment of a variety of renal conditions. He also has publications and interests relating to urologic imaging. He has contributed publications on treatment of urinary stone disease with newly developed technologies.
Dr. Bird is also an active member of the American Urological Association, Southeastern Section of the American Urological Association, Endourological Society, and past president of the Florida Urological Society. Dr. Bird has held a number of positions within the Florida Urologic Society, serving two terms as scientific director as well as secretary treasurer. He serves as a reviewer for a number of Urology based journals.
Associate Professor, Associate Program Director
Lebanon, New Hampshire
Vernon Pais is an endourologist with clinical and research focuses on urolithiasis. He is an associate professor at the Geisel School of Medicine at Dartmouth and serves as the director of urologic research and associate program director for the urology residency at Dartmouth.
Assistant Professor of Surgery
Penn State Milton S. Hershey Medical Center
Professor of Urology
UC San Diego Department of Urology
San Diego, California
University of Wisconsin School of Medicine and Public Health, Department of Urology
Stephen Y. Nakada, MD, FACS is Professor and founding Chairman of the Department of Urology and the David T. Uehling Chair of Urology at the University of Wisconsin School of Medicine and Public Health in Madison, WI. He received his medical degree from the University of Rochester School of Medicine and Dentistry, and completed his residency training at Strong Memorial Hospital in Rochester, NY. Dr. Nakada went on to complete his Endourology Fellowship at Washington University prior to joining the faculty at the University of Wisconsin in 1995. Dr. Nakada has been the Chairman of Urology in Madison since 2001.
Dr. Nakada's research focuses on urolithiasis and renal aspects of minimally invasive urology. He has authored or co-authored over 200 scientific articles, 50 book chapters, and he has edited more than 10 textbooks in those areas. In 2004, Dr. Nakada received the Gold Cystoscope Award and in 2017 he received the Distinguished Service Award from the AUA. He is currently an editorial consultant for Urology Times and an Assistant Editor of the Journal of Endourology.
Dr. Nakada has served as President of the R.O.C.K. Society, Society of Academic Urologists and the Endourological Society. He has served on the AUA Staghorn Stone and Ureteral Stones Guidelines Committees, the AUA/ABU Examination Committee, and he served as the Chair of the AUA Laparoscopy & Robotic Surgery Committee. Currently, Dr. Nakada is President of the American Board of Urology and a member of the Advisory Council in Urology to the American College of Surgeons. Dr. Nakada is an active member of the American Association of Genitourinary Surgeons and the Clinical Society of Genitourinary Surgeons, among other societies.
University of Wisconsin School of Medicine and Public Health, Department of Urology
Kristina Penniston is a scientist and registered dietitian nutritionist in Madison, Wisconsin. Dr. Penniston earned her PhD in nutritional science from the University of Wisconsin-Madison. She completed a dietetic internship at the University of Wisconsin Hospital and Clinics and is a certified dietitian member and fellow of the Academy of Nutrition and Dietetics. Dr. Penniston has provided clinical nutrition services to patients with kidney stones and other urologic diseases, such as urologic cancer and benign urologic conditions, for 20 years. Dr. Penniston's research in the Department of Urology at the University of Wisconsin School of Medicine and Public Health focuses on prevention of kidney stones. Specifically, her research aims to develop and test dietary interventions that prevent or ameliorate recurrent stones; promote patients' self-efficacy in managing their stone disease; and understand and improve patients’ health-related quality of life. Dr. Penniston has developed a porcine model of dietary-induced calcium oxalate urolithiasis as a platform for studying dietary influences on stone formation. She also helped to develop the Wisconsin Stone Quality of Life questionnaire, a stone-specific instrument to assess patients' health-related quality of life. Dr. Penniston is a member of the American Urological Association and is a former research scholar (2008-2010). She has been a member of the Research on Calculus Kinetics (ROCK) Society since 2008 and was elected in 2018 as secretary/treasurer. Dr. Penniston publishes regularly in urologic and nutrition journals.
Cleveland Clinic Foundation
Sri Sivalingam MD, MSc, FRCSC, is assistant professor of surgery at Cleveland Clinic Lerner College of Medicine at Case Western Reserve University. He is Director of the Center for Endourology and Stone Disease at Cleveland Clinic’s Hillcrest Hospital. Originally from Canada, he earned his Bachelors, Masters, and Medical degrees at the University of Toronto, and subsequently completed his urology residency at the University of Manitoba. He then completed a two-year fellowship in advanced Endourology and Minimally Invasive Surgery with a strong focus on urinary stone disease at the University of Wisconsin. He is board certified by both the American Board of Urology and the Royal College of Physicians and Surgeons of Canada.
Dr. Sivalingam's primary surgical, clinical, research and teaching interests include the treatment and prevention of urinary stone disease with several peer reviewed publications in this area. He is the co-director of the endourology research group and the fellowship program in stone disease at the Cleveland Clinic.