WCE 2016: Lost in the Wilderness: Kidney Stone Follow-up in an Urban Hospital - Session Highlights

Cape Town, South Africa (UroToday.com) Dr. Friedlander started with providing background information on underserved medical communities that have less access to care which leads to poorer medical outcomes.

These patients are not frequently studied and not accounted for in private payer administrative database studies. Patients with low annual household income are at increased risk of reporting kidney stones. Patients commonly express a desire for stone prevention and often not previously offered a metabolic workup. Stone clinic set up to serve these patients with a median household income $28,622 USD. Aimed to document rates of compliance with follow up and identify factors associated with submission of 24-hour urine collections

This was a retrospective study that evaluated first-time and recurrent stone formers without a prior metabolic evaluation and those who have had at least 9 months follow up. Patients were asked to submit a single 24-hour urine collection as part of their initial workup. Patients were divided into 2 groups based on successful submission of 24-hr urine vs. not. Univariate and multivariate analyses performed.

Authors revealed that 42% of patients submitted a 24-hour urine and 60% had post op imaging. Additionally, nearly 1/3 urine collections were improper. Logistic regression analysis demonstrated that the factors predictive of 24-hour urine submission were race and family history. Positive family history were more than twice as likely to be compliant for metabolic evaluation.

Authors concluded that further studies of underserved communities will help better understand factors associated with decreased compliance. Addressing these findings will help to improve management of kidney stone disease in this patient population.

Presented by Justin Friedlander, MD Assistant Professor of Urology, Fox Chase Cancer Center / Einstein Healthcare Network

Written By: Zhamshid Okhunov, MD, University of California, Irvine, USA, Department of Urology

34th World Congress of Endourology and SAUA meeting - November 7-12, 2016 – Cape Town, South Africa