Urology, University of Wisconsin - Madison

Medical Nutrition Therapy for Urolithiasis: Assessing Quality of Life

Funding:

American Urological Association

Principal Investigator:

Kris Penniston, PhD, RD and Stephen Y. Nakada, MD

Project Summary:

The proposed research addresses the health-related quality of life of patients with recurrent kidney stones and whether medical nutrition therapy for stone prevention improves patients’ quality of life. The health-related quality of life of stone formers has only recently been documented in a relatively small sample of stone formers at one institution (Penniston & Nakada, J Urol 2007;178:2435-2440). Stone disease is a chronic disease that may afflict an individual repeatedly over his/her lifetime, frequently resulting in pain, surgical and/or medical interventions, disruptions to work and family life, and, less commonly, kidney damage. Yet, in contrast to other chronic diseases which have been studied with respect to the quality of life of those afflicted, stone disease remains largely uncharacterized. While surgical interventions for stone removal have become less invasive over the years, resulting in reduced hospital stays and less pain to patients, long-term complications of even these newer techniques are now appreciated. In patients whose stone disease is very active, multiple surgeries, even the most minimally-invasive, confer added inconvenience and risk. Thus, the “cure” for stone disease has a price and is transient, at best, in many stone formers.

Appropriate medical management may significantly reduce treatment costs as well as recurrence rates and associated morbidity. Comprehensive care for patients that focuses on prevention may also result in greater satisfaction and quality of life. While the primary endpoint for treatment of urolithiasis has historically been a “stone-free” state, an outcome that may be especially relevant to patients is quality of life. As urolithiasis is rarely a fatal disease, interventions and disease management strategies that optimize patients’ quality of life is of great importance. Prevention of kidney stones with medical management is proven. Yet, patients’ acceptance of and compliance with medical management - which may include nutrition recommendations, medications, or both - has not been well-characterized. In order to understand if patients’ quality of life is enhanced with medical, particularly nutritional, management, we will assess patients’ attitudes towards and compliance with nutrition therapy for stone prevention. We will characterize the dietary patterns of new stone patients and compare them with those who have been following nutrition recommendations. Finally, we will develop a disease-specific tool by which to measure stone patients’ health-related quality of life.

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