Clinical and demographic factors associated with compliance and subsequent urinary metabolic changes in first-time ureteral stone formers

서지정보

ㆍ발행기관 : 충북대학교 동물의학연구소 ㆍ수록지정보 : Journal of Biomedical Research / 16권 / 2호
ㆍ저자명 : Sung Pil Seo, Ho Won Kang, Won Tae Kim, Yong-June Kim, Seok-Joong Yun, Wun-Jae Kim, Sang-Cheol Lee

목차

Introduction
Materials and Methods
Patient characteristics and data collection
Measurement and definition of parameters
Statistical analysis
Results
Baseline characteristics
Patient compliance with diet and lifestyle modification
Demographic and clinical factors are associated with patient compliance
Subsequent metabolic changes according to patient compliance
Discussion
Conclusions
Acknowledgements
ORCID
References

영어 초록

Dietary and lifestyle modifications are widely prescribed to prevent recurrence of urolithiasis, although little is known about the clinical and demographic factors associated with patient compliance and urinary metabolic changes. The present study assessed the clinical and demographic factors influencing compliance with a modified diet and lifestyle in first-time ureteric stone formers as well as determined the effects of compliance on urinary stone risk factors. We retrospectively reviewed the medical records of 53 patients presenting with ureteric calcium stones. Using a self-completed questionnaire, patients were classified according to compliance with seven recommendations for modifying diet and lifestyle into good compliance group (complied with ≥ three recommendations) and poor compliance group. Before (on a random diet) and after prescribing the modifications, 24 hour urine samples were collected from those in the good and poor compliance group. The stone size at presentation and initial treatment modality were closely associated with patient compliance (P=0.019, P=0.027, respectively). Citrate excretion significantly increased in the good compliance group after adopting modifications (P=0.012), whereas the poor compliance group did not show a statistically significant difference. Moreover, patients in the poor compliance group showed significantly increased urinary calcium excretion by the end of the study (P=0.040). After adjustments for age, sex, body mass index, and metabolic abnormality status, poor compliance was found to be an independent risk factor for persistence or development of hypocitraturia (OR: 3.885; 95% CI: 1.102~13.694; P=0.035). In conclusion, our results imply that patient education programs regarding diet and lifestyle should be tailored to the individual’s clinical and demographic characteristics.

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