Low income and non-White race are strongly associated with worse quality of life for nephrolithiasis patients.

Kidney stones are a source of significant morbidity and have been shown to negatively impact health-related quality of life (HRQoL). We aimed to understand the association between HRQoL, socioeconomic status (SES), and race among patients with kidney stones.

Kidney stone patients at 11 stone centers across the U.S. completed the Wisconsin Stone Quality of Life questionnaire (WISQOL). Patient ZIP codes were used to estimate household income. A mixed-effects regression model was used for analysis, with ZIP code as the random intercept.

A total of 2,057 stone formers completed WISQOL. Lower income was independently associated with significantly lower HRQoL (β = 0.372, p = 0.014), as were non-White race (β = -0.299, p = 0.001), unemployed work status (β = -0.291, p = 0.008), female gender (β = -0.204, p < 0.001), body mass index (BMI) over 40 (β = -0.380, p < 0.001), five or more medical comorbidities (β = -0.354, p = 0.001), severe recurrent stone formation (β = -0.146, p = 0.045), enrollment at an acute care visit or preoperative/postoperative appointment (β = -0.548, p < 0.001), and recent stone symptoms (β = -0.892, p < 0.001).

Lower income, non-White race, and unemployed work status were independently associated with lower HRQoL among patients with kidney stones. While clinical characteristics such as BMI and severity of stone disease were also associated with HRQoL, this study shows that socioeconomic factors are similarly important. Further research to understand the specific mechanisms by which SES and race impact health may lend insight into methods to optimize clinical management of stone formers and patients with other chronic diseases.

The Journal of urology. 2019 Mar 13 [Epub ahead of print]

Tessnim R Ahmad, David T Tzou, Manint Usawachintachit, Shalonda Reliford-Titus, Clinton Wu, Jeremy Goodman, Jodi A Antonelli, Davis P Viprakasit, Timothy D Averch, Sri Sivalingam, Ben H Chew, Vincent G Bird, Vernon M Pais, Necole M Streeper, Roger L Sur, Stephen Y Nakada, Kristina L Penniston, Thomas Chi

University of California , San Francisco., King Chulalongkorn Memorial Hospital , Bangkok , Thailand., UT Southwestern., University of North Carolina., University of Pittsburgh Medical Center., Cleveland Clinic., University of British Columbia , Vancouver., University of Florida Health., Dartmouth-Hitchcock., Penn State Health., University of California , San Diego., University of Wisconsin School of Medicine and Public Health.