Patient Characteristics Associated with Completion of 24-hour Urine Analyses Among Children and Adolescents with Nephrolithiasis.

To inform the development of strategies to improve adherence to guidelines, we sought to identify characteristics of pediatric patients with nephrolithiasis associated with completing 24-hour urine analyses.

We performed a retrospective cohort study of patients with nephrolithiasis aged 3 to 18 years treated in a large pediatric healthcare system from May 2012 to May 2017. Multivariable Cox models were fit to estimate the association between patient characteristics and completion of a 24-hour urine analysis.

Among 623 patients, 317 (50.9%) completed a 24-hour urine collection. Median age was 14.4 years (IQR 10.5, 16.3). In adjusted analyses, age at diagnosis (HR 1.03; 95% CI 1.01-1.07), renal colic on presentation (HR 1.72; 95% CI 1.15-2.58), and family history of nephrolithiasis (HR 1.50; 95% CI 1.17-1.93) were associated with an increased likelihood of completion of a 24-hour urine. Public/government assistance insurance (HR 0.68; 95% CI 0.48-0.96) was associated with decreased likelihood of completing a 24-hour urine.

Patients who had prior painful experiences with stones (renal colic), and potential better understanding of nephrolithiasis (family history, older age on presentation) were more likely to complete a 24-hour urine. Those patients with public insurance/government assistance were less likely to complete a 24-hour urine. These results can be used to develop strategies to improve pediatric patients' adherence to completing 24-hour urine collections.

Urology. 2019 Feb 20 [Epub ahead of print]

Albert S Lee, Laura McGarry, Diana K Bowen, Gregory E Tasian

Department of Urology, Einstein Healthcare Network, Philadelphia, PA 19141., Division of Urology, Ann and Robert H Lurie Children's Hospital of Chicago, Chicago, IL 60611; Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL 60611., Department of Surgery, Division of Pediatric Urology, The Children's Hospital of Philadelphia, Philadelphia, PA 19104; Department of Surgery, Division of Urology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104; Department of Biostatistics, Epidemiology, and Informatics Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104; Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104; Center for Pediatric Clinical Effectiveness, The Children's Hospital of Philadelphia, Philadelphia, PA 19104. Electronic address: .

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