Department of Surgery, Division of Urology, Cook County Health and Hospitals System, Chicago, IL, USA.
University of Idaho, Boise, ID, USA.
World J Urol. 2019 Aug;37(8):1723-1731. doi: 10.1007/s00345-018-2562-6. Epub 2018 Dec 15.
To assess knowledge of both promoting and preventive dietary factors on nephrolithiasis in a diverse patient population. Precipitating factors of kidney stone disease include diet, lifestyle, socioeconomic status, and race/ethnicity. However, patient awareness of these influences is poorly described.
A 24-question survey, assessing intake-related risk factors for stone disease, was administered prospectively to 1018 patients. Responses were summarized with frequency and percent. Statistical comparisons were made using a propensity scoring method in order to account for potential confounding variables. Propensity scores were stratified into quintiles. Further analysis with multiple imputation was performed to account for any missing data in the survey. The results of the propensity-adjusted log-binomial regression model are presented as prevalence ratios (PRs) and 95% confidence intervals (CIs).
Respondents demonstrated limited knowledge of nutrient factors that influence stone development. However, most study participants (70.3%) reported a willingness to make lifestyle changes aimed at lowering their risk for stone disease. Respondents reporting previous nephrolithiasis education were less likely to report that diet had no effect on kidney stone formation (PR = 0.795, 95% CI 0.65, 0.96, p = 0.01) The type of physician who counseled the respondent had no association with patient knowledge for stone disease (PR = 0.83, 95% CI 0.63, 1.10, p = 0.2).
Knowledge of diet-related risk factors for nephrolithiasis is limited among this population. Respondents who received prior education appeared to maintain the knowledge of dietary risk for nephrolithiasis. Participants also expressed a willingness to make requisite dietary changes if that information is provided. Given that most stone formers experience a recurrence, these findings highlight the need for more comprehensive patient education strategies on the modifiable risk factors for nephrolithiasis.
在多样化的患者群体中评估促进和预防肾结石的饮食因素相关知识。肾结石疾病的诱发因素包括饮食、生活方式、社会经济地位和种族/民族。然而，患者对这些影响的认识很差。
前瞻性地向 1018 名患者发放了一份 24 个问题的调查，评估与结石疾病相关的饮食相关危险因素。使用频率和百分比对结果进行总结。使用倾向评分法进行统计比较，以解释潜在的混杂变量。将倾向评分分层为五分位数。进一步分析采用多重插补法来解释调查中任何缺失的数据。调整倾向评分后的对数二项回归模型的结果以患病率比（PR）和 95%置信区间（CI）表示。
研究对象对影响结石形成的营养因素的知识有限。然而，大多数研究参与者（70.3%）表示愿意改变生活方式以降低患结石病的风险。报告曾接受过肾结石教育的参与者更不可能认为饮食对肾结石形成没有影响（PR=0.795，95%CI 0.65，0.96，p=0.01）。向受访者提供咨询的医生类型与患者对结石病的知识没有关联（PR=0.83，95%CI 0.63，1.10，p=0.2）。
该人群对肾结石相关饮食危险因素的知识有限。接受过教育的受访者似乎保持了对肾结石饮食风险的认识。如果提供相关信息，参与者也表示愿意进行必要的饮食改变。鉴于大多数结石患者会复发，这些发现突出了需要制定更全面的肾结石可修改风险因素患者教育策略。
