Category: Clinical Stones: Outcomes

MP13-5 - Understanding the Continuum of Health-Related Quality of Life in Renal Stone Formers

Fri, Sep 21
2:00 PM - 4:00 PM

Introduction & Objective :

Assessing health-related quality of life (HRQOL) in patients with nephrolithiasis is important. We are conducting a longitudinal cohort study to identify trends in HRQOL. In this study, we present interim data for the cohort after 5 months of open enrollment.


Methods : A pragmatic, longitudinal cohort study began enrollment in 10/2017. Any adult patient who presented to the urology clinic with imaging of a renal or ureteral stone and who was accessible for further clinical follow up was eligible for inclusion. Exclusion criteria included vulnerable populations, inability to speak English, or inability to use a computer independently. Enrolled subjects completed a total of 5 electronic disease-specific (WISQOL) and generic HRQOL instruments (PROMIS-29, -global health, -self-efficacy for managing symptoms and treatments; and EuroQoL) at enrollment and 1-month following treatment. Treatment was determined in a shared-decision making fashion and could include active surveillance (AS), spontaneous passage (SP), ureteroscopy (URS), or nephrolithotomy (PNL).


Results : A total of 51 subjects were screed with 39 completing the enrollment battery of HRQOL instruments. Of these 39, 36% (14/39) completed their 1-month battery, 20% (8/39) still had their 1-month battery date upcoming, and 44% (17/39) did not complete their 1-month battery. At enrollment, the median age was 56 (IQR: 46-64), 55% were male, 72% were Caucasian, 42% self-reported that this was their first stone, and the median self-reported number of stones was 3 (IQR: 1-3). The median largest stone size on imaging was 8 mm (IQR: 5-10 mm). The median scores of each instrument at enrollment are outlined in Table 1 (N=39). Of the 1-month responders (N=14), 36%, 14%, 36%, and 14% elected AS, SP, URS, and PNL, respectively. The change in scores of PROMIS-29 and self-efficacy from enrollment to 1-month are displayed in Figure 1 (N=14).


Conclusions : Patients experience their stone disease in different ways, but the dimensions of pain, anxiety, fatigue, and physical health are clearly degraded. There is a suggestion that treatment may improve these dimensions.

Justin B. Ziemba

Assistant Professor of Urology in Surgery
Perelman School of Medicine, University of Pennsylvania
Philadelphia, Pennsylvania

Hanna Stambakio

Perelman School of Medicine, University of Pennsylvania
Philadelphia, Pennsylvania

George Lin

Perelman School of Medicine, University of Pennsylvania
Philadelphia, Pennsylvania

Ian Berger

Perelman School of Medicine, University of Pennsylvania
Philadelphia, Pennsylvania

Ruchika Talwar

Perelman School of Medicine, University of Pennsylvania
Philadelphia, Pennsylvania

Gregory E. Tasian

Assistant Professor of Urology and Epidemiology
The Children's Hospital of Philadelphia
Philadelphia, Pennsylvania

Gregory Tasian, MD, MSc, MSCE is an Assistant Professor of Urology and Epidemiology and a Senior Scholar in the Center for Clinical Epidemiology and Biostatistics at the University of Pennsylvania Perelman School of Medicine. His clinical practice and research program are based at the Children’s Hospital of Philadelphia (CHOP), where he has faculty appointments in the Division of Urology and the Center for Pediatric Clinical Effectiveness. He is a practicing pediatric urologist with a clinical focus on kidney stone disease, and is Surgical Director of the Pediatric Kidney Stone Center at CHOP. His research is devoted to decreasing the lifetime burden of kidney stone disease, with a particular emphasis on clinical trials of interventions to improve health behaviors to decrease kidney stone recurrence, comparative effectiveness of surgical interventions for kidney stones, the environmental epidemiology of nephrolithiasis, and understanding the role of the gut microbiome in kidney stone disease. He also has an active research program in imaging classification and predictors of chronic kidney disease (CKD) progression for children with congenital abnormalities of the kidney and urinary tract.

Thomas Guzzo

Perelman School of Medicine, University of Pennsylvania
Philadelphia, Pennsylvania