Objective
To determine if socioeconomic status (SES) correlates with severity of kidney stone
disease and 24-hour urine parameters.
Materials and Methods
An IRB approved prospectively maintained database for nephrolithiasis was retrospectively
analyzed for both 24-hour urine results and surgical procedures performed from 2009
to 2019. Severely distressed communities (SDC) were categorized as those with a Distressed
Communities Index (DCI), a composite measure of SES, score in the top quartile (lowest
for SES). Univariate and multivariate analyses were performed to evaluate the strength
of the association of DCI on: stone size at presentation, need for and type of surgical
procedure, need for staged surgery and specific stone risk factors in 24-hour urine
collections.
Results
Surgical procedures were performed on 3939 patients (1978 women) who were not from
SDC and 200 (97 women) from SDC. Patients from SDC were older (57.1 years vs 54.2
years; P = .009). Patients from SDC were more likely to undergo proportionally more invasive
procedures (17.5% vs 11.6%; P = .011) and require staged surgery at a higher rate (13.0% vs 8.5%; P = .028). Men from SDC had larger stones (12.5 mm vs 9.7 mm; P = .001). Among 24-hour urine results from 2454 patients (1187 women), DCI was not
correlated with sodium, calcium, magnesium, volume, oxalate, phosphate, and pH levels.
Higher DCI (lower SES) correlated with lower urine citrate (P = .001) and lower urine potassium (P = .002).
Conclusion
SES correlates with larger stone burden at the time of urologic intervention, requires
proportionally more invasive procedures and more staged procedures. Lower SES correlated
with lower urine citrate and potassium.
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Article info
Publication history
Published online: September 26, 2020
Accepted:
September 17,
2020
Received:
June 10,
2020
Footnotes
Financial Disclosures: The authors declare that they have no relevant financial interests.
Identification
Copyright
© 2020 Elsevier Inc. All rights reserved.
