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      Gaps in kidney stone disease management: From clinical theory to patient reality

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          Abstract

          With nephrolithiasis projected to affect 25% of the global population in the next three decades, there is an urgent call for innovative management strategies to prevent and reduce stone recurrence. This study aims to explore the evolving management needs in nephrolithiasis from both patient and healthcare provider perspectives. An expert-collaborative online survey comprising 10 targeted questions on kidney stone management was developed and disseminated. This survey was designed to gather comprehensive insights from patients, physicians and dietician and other person in the field of nephrolithiasis. Analysis of responses from 120 participants, including 45 nephrologists, 38 dieticians, 11 urologists, and 14 kidney stones patients followed in our hospital, revealed critical insights. A significant 97.5% emphasized the necessity of optimizing daily water intake, and 94.1% recognized the need for practical dietary modifications. Additionally, 88.3% of respondents found timely hydration reminders beneficial. Notably, monitoring urine color and pH was valued by 85% and 84.3% of the participants, respectively. A striking disparity emerged in the perception of fatigue and wellness monitoring, with 65% of patients prioritizing fatigue monitoring, a view less shared by healthcare professionals. Similarly, 71% of patients deemed wellness monitoring essential, highlighting a gap in understanding between patients and their caregivers. This study underscores the critical need for more tailored guidance on hydration strategies and the promise of remote urine parameters monitoring in nephrolithiasis management. The findings strongly advocate for a patient-centered approach, aligning medical recommendations with patient lifestyles and experiences, to enhance the effectiveness of nephrolithiasis management.

          Supplementary Information

          The online version contains supplementary material available at 10.1007/s00240-024-01563-6.

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          Most cited references17

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          Determining the true burden of kidney stone disease

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            Economics and cost of care of stone disease.

            Yair Lotan (2008)
            Nephrolithiasis is associated with a high cost to society because of the high prevalence of disease and high recurrence rates. The total annual medical expenditures for urolithiasis in the United States were estimated at $2.1 billion in 2000. The cost of stone disease reflects the cost of health care services required to manage stone disease and the rate of utilization. Although the care of individuals with urolithiasis has shifted from the inpatient to the outpatient setting and the hospital length of stay has decreased, costs continue to rise because of increases in the prevalence of kidney stones. There are 2 potential areas that would allow for a decrease in stone disease-related costs, lower health care-related costs, and decreased prevalence of stone disease. Reducing treatment-related costs are unlikely to provide a solution to the high cost of caring for stone disease because physician-fee reductions did not result in a significant reduction in costs. Furthermore, there are no significant advancements in surgical technique or technologies in the horizon. One area of cost savings could be to develop better guidelines for acute management, optimizing timing for surgery in acute settings and increasing the practice of medical expulsive therapy. Another area with potential to reduce costs is the reduction of overall stone burden through the prevention of new stones or recurrences. Strategies for primary prevention in high-risk populations have not been studied and represent an area for future research. More efforts should be made to improve medical management of stone formers. These efforts include improving dietary recommendations, identifying barriers to evaluations and treatment of recurrent stone formers, improving patient compliance with recommendations, and development of new medications.
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              Kidney Stone Recurrence among Children and Adolescents.

              Kidney stone disease has become increasingly common during childhood and adolescence. However, the rate of symptomatic kidney stone recurrence for pediatric patients is uncertain. We sought to determine the recurrence rate of symptomatic kidney stones in a cohort of children with incident symptomatic nephrolithiasis.
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                Author and article information

                Contributors
                Agnieszka.Pozdzik@chu-brugmann.be
                Journal
                Urolithiasis
                Urolithiasis
                Urolithiasis
                Springer Berlin Heidelberg (Berlin/Heidelberg )
                2194-7228
                2194-7236
                9 April 2024
                9 April 2024
                2024
                : 52
                : 1
                : 61
                Affiliations
                [1 ]GRID grid.411371.1, ISNI 0000 0004 0469 8354, Department of Nephrology and Dialysis, , Kidney Stone Clinic, University Hospital Brugmann, ; Place A. Van Gehuchten 4, 1020 Brussels, Belgium
                [2 ]Faculty of Medecine, Université Libre de Bruxelles (ULB), ( https://ror.org/01r9htc13) Route de Lennik 808, 1070 Brussels, Belgium
                [3 ]MFP Haute Ecole de Vinci, Institut Paul Lambin, Place d’Alma 3, 1200 Brussels, Belgium
                [4 ]Department of Internal Medicine, and Charles and Jane Pak Center for Mineral Metabolism and Clinical Research, University of Texas Southwestern Medical Center, ( https://ror.org/05byvp690) Harry Hines Boulvards 5939, Dallas, TX 75390 USA
                Article
                1563
                10.1007/s00240-024-01563-6
                11004051
                38592424
                3b525f66-bf4c-4d53-a22a-28f483ae3b4e
                © The Author(s) 2024

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 7 March 2024
                : 22 March 2024
                Categories
                Review
                Custom metadata
                © Springer-Verlag GmbH Germany, part of Springer Nature 2024

                kidney stones disease,kidney stone management,kidney stone prevention,fluid intake,urine monitoring

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