Dei-05 Neighborhood Socioeconomic Disadvantage Is Associated With Worse Urinary Risk Factors and Access to Medical Management for Urolithiasis

You have accessJournal of UrologyDiversity, Equity & Inclusion Forum (DEI01)1 May 2024DEI-05 NEIGHBORHOOD SOCIOECONOMIC DISADVANTAGE IS ASSOCIATED WITH WORSE URINARY RISK FACTORS AND ACCESS TO MEDICAL MANAGEMENT FOR UROLITHIASIS Cyrus Chehroudi, Louisa Ho, Benjamin Jevnikar, Jorge Gutierrez-Aceves, Sri Sivalingam, Smita De, and Anna Zampini Cyrus ChehroudiCyrus Chehroudi , Louisa HoLouisa Ho , Benjamin JevnikarBenjamin Jevnikar , Jorge Gutierrez-AcevesJorge Gutierrez-Aceves , Sri SivalingamSri Sivalingam , Smita DeSmita De , and Anna ZampiniAnna Zampini View All Author Informationhttps://doi.org/10.1097/01.JU.0001008820.69436.91.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: 24-hour urine (24hU) testing guides counseling to prevent recurrent urolithiasis. Poor socioeconomic status (SES) is a risk factor for stone disease, however, these associations are often based on complex statistics not readily available in clinical practice. Area Deprivation Index (ADI) is a quantitative measure of SES that assigns a percentile based on mean income, education, employment, and housing quality from US census data using a geocoded residential address. ADI has been linked to peri-operative outcomes across multiple disciplines but not yet urolithiasis. This study aimed to characterize relationships between ADI and urolithiasis risk factors. METHODS: Retrospective review of patients undergoing percutaneous nephrolithotomy (PCNL) from 2017-2022 was performed. Addresses were geocoded to national ADI score, with the lowest quartile (scores 1-25) representing the least, and the top quartile (76-100) the most disadvantaged. Demographics, 24hU parameters, and stone composition data were evaluated. RESULTS: 1876 patients underwent PCNL during the study period, of which 909 completed a 24hU study. The distribution of gender and race was different across ADI quartiles, with more females and African Americans in the most disadvantaged quartile (55.5% vs 41.7%, p=.02; 16% vs. 4.5%, p<.001, respectively). Patients with poorest SES were less likely to undergo 24hU testing compared to the least disadvantaged quartile (44% vs. 63%, p<.001). Higher ADI score was significantly associated with lower 24hU volume, citrate and pH. Conversely, there was a trend towards increased 24hU uric acid among lower ADI (p=.052). Struvite and calcium phosphate stones were more common among poorer SES, whereas mixed calcium stones were more prevalent amongst the lowest ADI quartile. CONCLUSIONS: Higher ADI is associated with multiple risk factors for recurrent urolithiasis including failure to complete 24hU studies, hypocitraturia, low urinary pH, and low urinary volume. Stone types amenable to medical management were more prevalent amongst higher ADIs. ADI may serve as a simple clinical tool to identify patients at risk for SES limiting comprehensive endourologic care. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e289 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Cyrus Chehroudi More articles by this author Louisa Ho More articles by this author Benjamin Jevnikar More articles by this author Jorge Gutierrez-Aceves More articles by this author Sri Sivalingam More articles by this author Smita De More articles by this author Anna Zampini More articles by this author Expand All Advertisement PDF downloadLoading ...