The impact of bilateral stone disease on patients' disease progression and health related quality of life.

Purpose Patients with recurring kidney stone events can expect significant morbidity and functional impairment. Few studies have evaluated the effect of bilateral kidney stones on disease progression and quality of life. We wanted to determine the association of bilateral stone disease on age of onset, and the impact on number of stone events and individual kidney stone disease specific Health Related Quality of Life (HRQOL) by analysing the validated and prospectively collected Wisconsin Stone Quality of Life (WISQOL) database. Material and Methods We studied 2,906 stone patients from 16 centers in North America after having completed the WISQOL questionnaire from 2014 to 2019. Kidney stone formers were assessed if kidney stones were bilateral or unilateral on imaging. Analysis with a Chi-square test compared categorical variables. Bilateral kidney stone disease and its impact on HRQOL was evaluated through a multivariable linear regression model. Results Of 2,906 kidney stone formers, 1,340 had unilateral kidney stones and 1,566 had bilateral kidney stones. We observed more frequently that patients with bilateral stones had an increased number of depression/anxiety symptoms, renal tubular acidosis, and rheumatoid arthritis (all p<0.05). Patients with bilateral stones had a younger mean (SD) age of kidney stone disease onset (37.2±15.8 vs 46.4±15.9 years of age, p<0.001). Bilateral kidney stone formers had a higher mean (SD) number of stone events (11.3±21.8) than unilateral kidney stone formers (3.0±5.1) (p<0.001). Within our multivariable analysis, we found that HRQOL was negatively affected by the presence of bilateral stones for kidney stone patients (β=-11.2 (CI:-19.5 - -3.0) points, p<0.05). Conclusion Bilateral kidney stone formers had a younger age of kidney stone disease onset and a higher number of stone events compared to unilateral kidney stone disease formers. Presence of bilateral kidney stone disease negatively impacted HRQOL.

Journal of endourology. 2023 Sep 28 [Epub ahead of print]

Brendan Raizenne, Claudia Deyirmendjian, Marie-Lyssa Lafontaine, Maimouna Balde, Seth K Bechis, Roger L Sur, Stephen Y Nakada, Jodi A Antonelli, Necole M Streeper, Sri Sivalingam, Davis Viprakasit, Timothy D Averch, Jaime Landman, Thomas Chi, Vernon M Pais, Ben H Chew, Vincent Bird, Sero Andonian, Noah E Canvasser, Jonathan D Harper, Kristina L Penniston, Naeem Bhojani

Centre hospitalier de l'Université de Montréal, Division of Urology, 900 rue saint-denis, Montréal, Quebec, Canada, H2X 0A9; ., Université de Montréal, 5622, Medicine, 5810 Rue Belherbe, Montreal, Montreal, Quebec, Canada, H1P1E9; ., University of Montreal Faculty of Medicine, 12368, Montreal, Quebec, Canada; ., Gaston Berger University, 231171, Saint-Louis, Senegal; ., University of California San Diego Health System, 21814, Urology, 200 W Arbor Drive MC8897, San Diego, California, United States, 92103., UC San Diego, 8784, Urology, Department of Urology, 200 Arbor Drive #8897, San Diego, California, United States, 92130., 1685 Highland AveMadison, Wisconsin, United States, 53705; ., Duke University, 3065, Surgery, Durham, North Carolina, United States; ., Pennsylvania State University Department of Surgery, 328945, Surgery, Hershey, Pennsylvania, United States; ., University of Wisconsin, Urology, 3108 Bluff Street, apt 5, Madison, Wisconsin, United States, 53705; ., UNC, Urology, 2114 POB, Campus Box 7235, Chapel Hill, North Carolina, United States, 27599; ., Prisma Health Midlands, 2630, Dept. of Surgery; Division of Urology, 1301 Taylor St, Suite 1A, Columbia, South Carolina, United States, 29201., University of California Irvine, Urology, 333 City Blvd West, Orange, California, United States, 92868; ., University of California San Francisco, Urology, 400 Parnassus Ave, 6th floor Urology Clinics A638, San Francisco, California, United States, 94143; ., Dartmouth Hitchcock Medical Center, Urology, Lebanon, New Hampshire, United States; ., University of British Columbia, Urologic Sciences, Level 6, 2775 Laurel st., Level 6 - 2775 Laurel St, Vancouver, British Columbia, Canada, V5Z 1M9., University of Florida, Urology, 1600 SW Archer Road, Box 100247, Gainesville, Florida, United States, 32610; ., McGill University Health Centre, 54473, Division of Urology, Montreal, Quebec, Canada; ., University of California Davis Health System, 70083, Urologic Surgery, 4860 Y Street, Suite 3500, Sacramento, California, United States, 95817., University of Washington, Seattle, United States; ., University of Wisconsin School of Medicine and Public Health, Urology, 1685 Highland Avenue, 3258 MFCB, Madison, Wisconsin, United States, 53705-2281; ., Centre Hospitalier de L'Universite de Montreal, 25443, Urology, 900 St. Denis street, Pavillon R, R08.474, Montreal, Quebec, Canada, H2X 0A9; .