The Wisconsin Stone Quality of Life Questionnaire (WISQOL), a stone specific HRQOL questionnaire, was used to survey 3,051 patients with kidney stones. Medical history was collected from patients. This data was used to distinguish MetS patients from non-MetS patients. Among patients with current stones, a Wilcoxon rank sum test was used to compare HRQOL scores from MetS patients and non-MetS patients. HRQOL from patients with and without individual MetS components were also compared, and a multivariate analysis was conducted. Among kidney stone patients without stones at the time of questionnaire completion, another Wilcoxon rank sum test was used to compare MetS patients and non-MetS patients.
Statistical comparison between MetS patients (median score 102/140) and non-MetS patients (median score 106/140) demonstrated a lower stone specific HRQOL in patients with MetS (p = 0.049). Among individual MetS components, patients with diabetes mellitus (DM) or body mass index (BMI) > 30 had significantly lower HRQOL than patients without DM or BMI < 30 respectively (p=0.028, p<0.001). The multivariate analysis supported this trend as MetS remained a significant predictor of decreased HRQOL (p =0.002) after controlling for other variables assessed. When comparing MetS and non-MetS patients without stones, there was no significant difference in HRQOL (p=0.24).
The results of this study indicate an association between MetS and a lower stone specific quality of life. Further, the fact that comparing MetS and non-MetS patients without stones yields no significant difference (p=0.24) confirms the hypothesis that it is the combination of stones and MetS that results in decreased stone specific HRQOL. While the link between MetS and nephrolithiasis is established, we believe this is the first study that demonstrates an adverse effect on the HRQOL of patients with active stone disease and MetS. This has important implications for stone prevention strategies in patients with MetS. Specifically, a more holistic view of outpatient stone prevention can be adopted. To this end, physicians may consider aiming to reduce the severity of MetS through advising lifestyle and diet changes in addition to treating kidney stones.
Written by: Jonathan Lim, Kymora Scotland, Seth K Bechis, Roger L Sur, Stephen Y Nakada, Jodi A Antonelli, Nicole Streeper, Sri Sivalingam, Davis Viprakasit, Timothy D Averch, Jaime Landman, Thomas Chi, Vernon M Pais, Vincent Bird, Sero Andonian, Naeem Bhojani, Noah E Canvasser, Jonathan D Harper, Kristina L Penniston, Ben H Chew
University of British Columbia, Urologic Sciences, 6th Floor, 2775 Laurel Street, Vancouver, British Columbia, Canada, V5Z 1M9; ., The University of British Columbia, 8166, 2775 Laurel Street, Vancouver, British Columbia, Canada, V6T 1Z4; ., University of California San Diego Health System, 21814, Urology, San Diego, California, United States; ., University of California San Diego, 8784, Urology, Department of Urology, 200 Arbor Drive #8897, San Diego, California, United States, 92103., 1685 Highland AveMadison, Wisconsin, United States, 53705; ., UT Southwestern Medical Center, Urology, 5323 Harry Hines Blvd J8.106, Dallas, Texas, United States, 75390-9110; ., Penn State, 8082, University Park, Pennsylvania, United States; ., The Cleveland Clinic, Urology, Glickman Urological & Kidney Institute, Cleveland, Ohio, United States; ., UNC, Urology, 2114 POB, Campus Box 7235, Chapel Hill, North Carolina, United States, 27599; ., Palmetto Health USC Medical Group, Dept. of Surgery; Division of Urology, 2 Richmond Medical Park Drive - Ste 306, Columbia, South Carolina, United States, 29203., University of California Irvine, Urology, 333 City Blvd West, Orange, California, United States, 92868; ., University of California San Francisco, Urology, 400 Parnassus Ave, 6th floor Urology Clinics A638, San Francisco, California, United States, 94143; ., Dartmouth Hitchcock Medical Center, Urology, Lebanon, New Hampshire, United States; ., University of Florida, Urology, 1600 SW Archer Road, Box 100247, Gainesville, Florida, United States, 32610; ., McGill University Health Cntre, Urology, 1001 Boul Decarie, Suite D05.5331, Montreal, Quebec, Canada, H4A 3J1; ., Centre Hospitalier de L'Universite de Montreal, 25443, Urology, 900 St. Denis street, Pavillon R, R08.474, Montreal, Quebec, Canada, H2X 0A9; ., University of California Davis Health System, 70083, Urologic Surgery, 4860 Y Street, Suite 3500, Sacramento, California, United States, 95817., University of Washington, Department of Urology, 1959 NE Pacific Street, Box 356510, Seattle, Washington, United States, 98195; ., University of Wisconsin School of Medicine and Public Health, Urology, 1685 Highland Avenue, 3258 MFCB, Madison, Wisconsin, United States, 53705-2281; ., University of British Columbia, Urologic Sciences, Level 6, 2775 Laurel st., Level 6 - 2775 Laurel St, Vancouver, British Columbia, Canada, V5Z 1M9.
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