Determinants of quality of life for patients with kidney stones

Purpose: We evaluated various factors relating to quality of life in a population of patients with stones. Materials and Methods: A total of 155 patients seen at our urology clinic for stones between January and May 2007 were prospectively questioned regarding stone history and were administered the SF-36 (TM) questionnaire to assess quality of life. Age, body mass index, American Society of Anesthesiologists score, number of stone episodes, interval from the last stone episode, number of surgical procedures for stones and associated complications, missed days of work and long-term medical treatment were elicited from the patients. Individual SF-36 domains and composite scores were compared to those of the American general population. Univariate and multivariate regression analyses were performed to assess the impact of all covariates on quality of life scores. Results: Patients with stones scored lower than the average American population in 5 of the 8 domains of the SF-36 as well as in the physical composite score. Multivariate regression modeling showed that increasing body mass index and age were the strongest predictors of decreased physical well-being. The number of stone episodes did not influence SF-36 scores, although the number of surgical procedures impacted physical and mental components. The number of ureteroscopy procedures and stent placements primarily impacted mental well-being. Medical therapy, particularly the use of potassium citrate, was associated with more favorable quality of life. Conclusions: Various factors impact quality of life in patients with urolithiasis but the most important are body mass index, age and the number of surgical procedures. Prospective longitudinal studies may further elucidate the determinants of quality of life and they might be used to optimize patient care.