Division of Urology, Centre Hospitalier de l'Université de Montréal, Montréal, Quebec, Canada.
Department of Urology, University of California San Diego, San Diego, CA, USA.
BJU Int. 2024 May;133(5):570-578. doi: 10.1111/bju.16294. Epub 2024 Feb 8.
To assess the impact of kidney stone disease (KSD) and its treatment on the health-related quality of life (HRQOL) of high-risk stone formers with hyperparathyroidism, renal tubular acidosis, malabsorptive disease, and medullary sponge kidney.
The Wisconsin Stone Quality of Life questionnaire was used to evaluate HRQOL in 3301 patients with a history of KSD from 16 institutions in North America between 2014 and 2020. Baseline characteristics and medical history were collected from patients, while active KSD was confirmed through radiological imaging. The high-risk group was compared to the remaining patients (control group) using the Wilcoxon rank-sum test.
Of 1499 patients with active KSD included in the study, the high-risk group included 120 patients. The high-risk group had significantly lower HRQOL scores compared to the control group (P < 0.01). In the multivariable analyses, medullary sponge kidney disease and renal tubular acidosis were independent predictors of poorer HRQOL, while alkali therapy was an independent predictor of better HRQOL (all P < 0.01).
Among patients with active KSD, high-risk stone formers had impaired HRQOL with medullary sponge kidney disease and renal tubular acidosis being independent predictors of poorer HRQOL. Clinicians should seek to identify these patients earlier as they would benefit from prompt treatment and prevention.
评估甲状旁腺功能亢进、肾小管酸中毒、吸收不良性疾病和海绵肾等高危结石形成者的肾结石病(KSD)及其治疗对健康相关生活质量(HRQOL)的影响。
2014 年至 2020 年,来自北美 16 个机构的 3301 名有 KSD 病史的患者使用威斯康星结石生活质量问卷评估 HRQOL。从患者处收集基线特征和病史,通过影像学检查确认活动性 KSD。使用 Wilcoxon 秩和检验将高危组与其余患者(对照组)进行比较。
在纳入研究的 1499 名有活动性 KSD 的患者中,高危组包括 120 名患者。高危组的 HRQOL 评分明显低于对照组(P<0.01)。在多变量分析中,海绵肾疾病和肾小管酸中毒是 HRQOL 较差的独立预测因素,而碱治疗是 HRQOL 较好的独立预测因素(均 P<0.01)。
在有活动性 KSD 的患者中,高危结石形成者的 HRQOL 受损,海绵肾疾病和肾小管酸中毒是 HRQOL 较差的独立预测因素。临床医生应尽早识别这些患者,因为他们将受益于及时的治疗和预防。