Low Income and Nonwhite Race are Strongly Associated with Worse Quality of Life in Patients with Nephrolithiasis

Tessnim R. Ahmad, David T. Tzou, Manint Usawachintachit, Shalonda Reliford-Titus, Clinton Wu, Jeremy Goodman, Jodi Antonelli, Davis P. Viprakasit, Timothy D. Averch, Sri Sivalingam, Ben H. Chew, Vincent G. Bird, Vernon M. Pais, Necole M. Streeper, Roger L. Sur, Stephen Y. Nakada, Kristina L. Penniston, Thomas Chi

Research output: Contribution to journalArticle

Abstract

PURPOSE: Kidney stones are a source of significant morbidity which have been shown to negatively impact health related quality of life. We sought to understand the association between health related quality of life, socioeconomic status and race among patients with kidney stones. MATERIALS AND METHODS: Patients with stones at a total of 11 stone centers across the United States completed the WISQOL (Wisconsin Stone Quality of Life questionnaire). The patient ZIP Code™ was used to estimate household income. A mixed effects regression model was constructed for analysis with ZIP Code as the random intercept. RESULTS: A total of 2,057 stone formers completed the WISQOL. Lower income was independently associated with significantly lower health related quality of life (β = 0.372, p = 0.014), as were nonwhite race (β = -0.299, p = 0.001), unemployed work status (β = -0.291, p = 0.008), female gender (β = -0.204, p <0.001), body mass index greater than 40 kg/m2 (β = -0.380, p <0.001), 5 or more medical comorbidities (β = -0.354, p = 0.001), severe recurrent stone formation (β = -0.146, p = 0.045), enrollment at an acute care visit, or a preoperative or postoperative appointment (β = -0.548, p <0.001) and recent stone symptoms (β = -0.892, p <0.001). CONCLUSIONS: Lower income, nonwhite race and unemployed work status were independently associated with lower health related quality of life among patients with kidney stones. While clinical characteristics such as body mass and stone disease severity were also associated with health related quality of life, this study shows that socioeconomic factors are similarly important. Further research to understand the specific mechanisms by which socioeconomic status and race impact health may lend insight into methods to optimize clinical treatment of stone formers and patients with other chronic diseases.

Original languageEnglish (US)
Pages (from-to)119-124
Number of pages6
JournalThe Journal of urology
Volume202
Issue number1
DOIs
StatePublished - Jul 1 2019

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Nephrolithiasis
Quality of Life
Kidney Calculi
Social Class
Comorbidity
Appointments and Schedules
Body Mass Index
Chronic Disease
Morbidity
Health
Research

Keywords

  • continental population groups
  • kidney calculi
  • quality of life
  • socioeconomic factors
  • unemployment

ASJC Scopus subject areas

  • Urology

Cite this

Ahmad, T. R., Tzou, D. T., Usawachintachit, M., Reliford-Titus, S., Wu, C., Goodman, J., ... Chi, T. (2019). Low Income and Nonwhite Race are Strongly Associated with Worse Quality of Life in Patients with Nephrolithiasis. The Journal of urology, 202(1), 119-124. https://doi.org/10.1097/JU.0000000000000233

Low Income and Nonwhite Race are Strongly Associated with Worse Quality of Life in Patients with Nephrolithiasis. / Ahmad, Tessnim R.; Tzou, David T.; Usawachintachit, Manint; Reliford-Titus, Shalonda; Wu, Clinton; Goodman, Jeremy; Antonelli, Jodi; Viprakasit, Davis P.; Averch, Timothy D.; Sivalingam, Sri; Chew, Ben H.; Bird, Vincent G.; Pais, Vernon M.; Streeper, Necole M.; Sur, Roger L.; Nakada, Stephen Y.; Penniston, Kristina L.; Chi, Thomas.

In: The Journal of urology, Vol. 202, No. 1, 01.07.2019, p. 119-124.

Research output: Contribution to journalArticle

Ahmad, TR, Tzou, DT, Usawachintachit, M, Reliford-Titus, S, Wu, C, Goodman, J, Antonelli, J, Viprakasit, DP, Averch, TD, Sivalingam, S, Chew, BH, Bird, VG, Pais, VM, Streeper, NM, Sur, RL, Nakada, SY, Penniston, KL & Chi, T 2019, 'Low Income and Nonwhite Race are Strongly Associated with Worse Quality of Life in Patients with Nephrolithiasis', The Journal of urology, vol. 202, no. 1, pp. 119-124. https://doi.org/10.1097/JU.0000000000000233
Ahmad, Tessnim R. ; Tzou, David T. ; Usawachintachit, Manint ; Reliford-Titus, Shalonda ; Wu, Clinton ; Goodman, Jeremy ; Antonelli, Jodi ; Viprakasit, Davis P. ; Averch, Timothy D. ; Sivalingam, Sri ; Chew, Ben H. ; Bird, Vincent G. ; Pais, Vernon M. ; Streeper, Necole M. ; Sur, Roger L. ; Nakada, Stephen Y. ; Penniston, Kristina L. ; Chi, Thomas. / Low Income and Nonwhite Race are Strongly Associated with Worse Quality of Life in Patients with Nephrolithiasis. In: The Journal of urology. 2019 ; Vol. 202, No. 1. pp. 119-124.
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abstract = "PURPOSE: Kidney stones are a source of significant morbidity which have been shown to negatively impact health related quality of life. We sought to understand the association between health related quality of life, socioeconomic status and race among patients with kidney stones. MATERIALS AND METHODS: Patients with stones at a total of 11 stone centers across the United States completed the WISQOL (Wisconsin Stone Quality of Life questionnaire). The patient ZIP Code™ was used to estimate household income. A mixed effects regression model was constructed for analysis with ZIP Code as the random intercept. RESULTS: A total of 2,057 stone formers completed the WISQOL. Lower income was independently associated with significantly lower health related quality of life (β = 0.372, p = 0.014), as were nonwhite race (β = -0.299, p = 0.001), unemployed work status (β = -0.291, p = 0.008), female gender (β = -0.204, p <0.001), body mass index greater than 40 kg/m2 (β = -0.380, p <0.001), 5 or more medical comorbidities (β = -0.354, p = 0.001), severe recurrent stone formation (β = -0.146, p = 0.045), enrollment at an acute care visit, or a preoperative or postoperative appointment (β = -0.548, p <0.001) and recent stone symptoms (β = -0.892, p <0.001). CONCLUSIONS: Lower income, nonwhite race and unemployed work status were independently associated with lower health related quality of life among patients with kidney stones. While clinical characteristics such as body mass and stone disease severity were also associated with health related quality of life, this study shows that socioeconomic factors are similarly important. Further research to understand the specific mechanisms by which socioeconomic status and race impact health may lend insight into methods to optimize clinical treatment of stone formers and patients with other chronic diseases.",
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T1 - Low Income and Nonwhite Race are Strongly Associated with Worse Quality of Life in Patients with Nephrolithiasis

AU - Ahmad, Tessnim R.

AU - Tzou, David T.

AU - Usawachintachit, Manint

AU - Reliford-Titus, Shalonda

AU - Wu, Clinton

AU - Goodman, Jeremy

AU - Antonelli, Jodi

AU - Viprakasit, Davis P.

AU - Averch, Timothy D.

AU - Sivalingam, Sri

AU - Chew, Ben H.

AU - Bird, Vincent G.

AU - Pais, Vernon M.

AU - Streeper, Necole M.

AU - Sur, Roger L.

AU - Nakada, Stephen Y.

AU - Penniston, Kristina L.

AU - Chi, Thomas

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N2 - PURPOSE: Kidney stones are a source of significant morbidity which have been shown to negatively impact health related quality of life. We sought to understand the association between health related quality of life, socioeconomic status and race among patients with kidney stones. MATERIALS AND METHODS: Patients with stones at a total of 11 stone centers across the United States completed the WISQOL (Wisconsin Stone Quality of Life questionnaire). The patient ZIP Code™ was used to estimate household income. A mixed effects regression model was constructed for analysis with ZIP Code as the random intercept. RESULTS: A total of 2,057 stone formers completed the WISQOL. Lower income was independently associated with significantly lower health related quality of life (β = 0.372, p = 0.014), as were nonwhite race (β = -0.299, p = 0.001), unemployed work status (β = -0.291, p = 0.008), female gender (β = -0.204, p <0.001), body mass index greater than 40 kg/m2 (β = -0.380, p <0.001), 5 or more medical comorbidities (β = -0.354, p = 0.001), severe recurrent stone formation (β = -0.146, p = 0.045), enrollment at an acute care visit, or a preoperative or postoperative appointment (β = -0.548, p <0.001) and recent stone symptoms (β = -0.892, p <0.001). CONCLUSIONS: Lower income, nonwhite race and unemployed work status were independently associated with lower health related quality of life among patients with kidney stones. While clinical characteristics such as body mass and stone disease severity were also associated with health related quality of life, this study shows that socioeconomic factors are similarly important. Further research to understand the specific mechanisms by which socioeconomic status and race impact health may lend insight into methods to optimize clinical treatment of stone formers and patients with other chronic diseases.

AB - PURPOSE: Kidney stones are a source of significant morbidity which have been shown to negatively impact health related quality of life. We sought to understand the association between health related quality of life, socioeconomic status and race among patients with kidney stones. MATERIALS AND METHODS: Patients with stones at a total of 11 stone centers across the United States completed the WISQOL (Wisconsin Stone Quality of Life questionnaire). The patient ZIP Code™ was used to estimate household income. A mixed effects regression model was constructed for analysis with ZIP Code as the random intercept. RESULTS: A total of 2,057 stone formers completed the WISQOL. Lower income was independently associated with significantly lower health related quality of life (β = 0.372, p = 0.014), as were nonwhite race (β = -0.299, p = 0.001), unemployed work status (β = -0.291, p = 0.008), female gender (β = -0.204, p <0.001), body mass index greater than 40 kg/m2 (β = -0.380, p <0.001), 5 or more medical comorbidities (β = -0.354, p = 0.001), severe recurrent stone formation (β = -0.146, p = 0.045), enrollment at an acute care visit, or a preoperative or postoperative appointment (β = -0.548, p <0.001) and recent stone symptoms (β = -0.892, p <0.001). CONCLUSIONS: Lower income, nonwhite race and unemployed work status were independently associated with lower health related quality of life among patients with kidney stones. While clinical characteristics such as body mass and stone disease severity were also associated with health related quality of life, this study shows that socioeconomic factors are similarly important. Further research to understand the specific mechanisms by which socioeconomic status and race impact health may lend insight into methods to optimize clinical treatment of stone formers and patients with other chronic diseases.

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KW - kidney calculi

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KW - socioeconomic factors

KW - unemployment

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