Quality of Life Among Prevalent Kidney Stone Formers

Background: Quality-of-life (QOL) measures have not been well studied among kidney stone formers (KSF). Here, we aim to investigate the determinants and prognostic value of QOL in this unique patient population. Methods: We examined QOL measurements (SF-12 and Healthy Days Measures) among prevalent KSF and the associated risk of death using the National Health and Nutrition Examination Surveys (NHANES) III, 2007-2018, and their linked mortality file. Depending on the outcome measures, both logistic regression and Cox regression models were used. Results: 43,917 participants were eligible for the final analysis, including 3,514 KSF. KSF tended to be non-Hispanic, white males, and had lower socioeconomic status (SES). KSF had significantly lower QOL measured by SF12 compared to non-KSF in both unadjusted and adjusted logistic regression analyses (Figure 1), and the overall QOL measures did not change over time, p=0.40. According to the Healthy Days questionnaire conducted from 2007 to 2012, both physical health and pain scores were significantly worse, and there was also a trend toward worse mental health among KSF in the regression analysis (Table 1). Lastly, poor QOL measures among KSF is strongly associated with higher all-cause and cardiovascular mortalities (Figure 2). Conclusion: KSF had worse QOL compared to non-KSF, and QOL significantly predicted survival. Among KSF, both physical health and pain appeared to account for the poor QOLHealthy Days Measures, NHANES 2007 -2012 subset (n=14,576) - KSF No KSF Unadjusted analysis Adjusted analysis Days (n) Weighted % Unweighted n Weighted % Unweighted n P-value OR (95% CI), P-value Poor physical health Zero1-1516-30 59.230.510.3 735410171 66.625.77.7 8,58734971,176 <0.001 1.21 (1.04-1.40) P=0.01 Poor mental health Zero1-1516-30 58.929.711.3 788379149 58.633.08.4 8,0214,0701,169 0.006 1.14 (0.99-1.32) P=0.07 Inactivity due to poor physical/mental health Zero1-1516-30 75.718.45.8 97924790 80.515.44.1 10,7051,968587 0.002 1.19 (0.99-1.44) P=0.06 Pain causing difficulty in usual activity Zero1-1516-30 58.027.114.8 763336217 70.321.28.5 9,3082,7761,176 <0.001 1.40 (1.23-1.59) P<0.001 Multiple ordinal logistic regression; adjusted of sex, age, race, insurance, education, BMI, HTN, DM, smoking and alcohol.