Mp45-10 24-Hour Urine Parameters of Stone-Forming Patients With Severe Cognitive and Physical Impairment

You have accessJournal of UrologyStone Disease: Epidemiology & Evaluation II (MP45)1 May 2024MP45-10 24-HOUR URINE PARAMETERS OF STONE-FORMING PATIENTS WITH SEVERE COGNITIVE AND PHYSICAL IMPAIRMENT Katy Su, Cristofer Zillo, Jonathan Aronov, Jason Zhang, Jennifer Y. Lu, Jose Torres, Kerry Adler, Eric J. Miller, and David Schulsinger Katy SuKaty Su , Cristofer ZilloCristofer Zillo , Jonathan AronovJonathan Aronov , Jason ZhangJason Zhang , Jennifer Y. LuJennifer Y. Lu , Jose TorresJose Torres , Kerry AdlerKerry Adler , Eric J. MillerEric J. Miller , and David SchulsingerDavid Schulsinger View All Author Informationhttps://doi.org/10.1097/01.JU.0001008764.86460.8e.10AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Patients with disabilities have increased risk of nephrolithiasis due to risk factors, including increased immobilization, infections, and difficulty regulating nutrition or fluid intake. We investigated the 24-hour urine of patients after undergoing percutaneous nephrolithotomy (PCNL) to investigate if patients with disabilities had different underlying lithogenic risk factors. METHODS: Retrospectively, all patients who underwent PCNL from 1/1/2020-3/30/2023 at a single institution were reviewed. Patients were included if they had a post-operative 24-hour urine study completed after complete removal of all stones. They were then grouped based on their diagnosis of cognitive and/or physical disability and patients were compared using T-tests via R software. RESULTS: 94 patients (39 female, 55 male, mean age 61.7 years) were included and 21 of which had severe cognitive and physical impairment and fully dependent for all activities of daily living. 57% of patients had a component of struvite stones and 95% of patients has a component of calcium phosphate stones despite none being diagnosed with hyperparathyroidism or renal tubular acidosis. 24-hour urine revealed these patients had a significantly reduced volume (1.32 L vs 1.91 L p=0.016) and increased urinary pH (6.95 vs 5.80, p<0.001) when compared to patients without cognitive and physical disabilities. Compared to the control group of patients without special needs, patients with severe debilitating impairments also had significantly reduced urinary calcium (103 mg vs. 182 mg, p=0.019), uric acid (0.31 g vs. 0.61 g, p<0.001), sodium (79 mmol vs. 147 mmol, p<0.001), and phosphorus (0.40 g vs. 0.81 g, p<0.001). No difference was seen for urinary oxalate, citrate, potassium or magnesium. CONCLUSIONS: There are significant differences in the underlying processes of nephrolithiasis for patients who have severe physical and intellectual disabilities which have not been studied prior. The relatively decreased volume puts patients at higher risk for overall stone formation. In particular, this population showed a very high percentage of struvite and calcium phosphate stones which is likely precipitated by highly alkaline urine. Patients with disabilities face significant healthcare barriers and changing urine parameters may be particularly difficult to intervene on. This study shows specific identifiable risk factors for this population to target. Source of Funding: The authors have no sources of funding to disclose © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e746 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Katy Su More articles by this author Cristofer Zillo More articles by this author Jonathan Aronov More articles by this author Jason Zhang More articles by this author Jennifer Y. Lu More articles by this author Jose Torres More articles by this author Kerry Adler More articles by this author Eric J. Miller More articles by this author David Schulsinger More articles by this author Expand All Advertisement PDF downloadLoading ...