To inform the development of strategies to improve adherence to guidelines, we sought to identify characteristics of pediatric patients with nephrolithiasis associated with completing 24-hour urine analyses.
We performed a retrospective cohort study of patients with nephrolithiasis aged 3 to 18 years treated in a large pediatric healthcare system from May 2012 to May 2017. Multivariable Cox models were fit to estimate the association between patient characteristics and completion of a 24-hour urine analysis.
Among 623 patients, 317 (50.9%) completed a 24-hour urine collection. Median age was 14.4 years (IQR 10.5, 16.3). In adjusted analyses, age at diagnosis (HR 1.03; 95% CI 1.01-1.07), renal colic on presentation (HR 1.72; 95% CI 1.15-2.58), and family history of nephrolithiasis (HR 1.50; 95% CI 1.17-1.93) were associated with an increased likelihood of completion of a 24-hour urine. Public/government assistance insurance (HR 0.68; 95% CI 0.48-0.96) was associated with decreased likelihood of completing a 24-hour urine.
Patients who had prior painful experiences with stones (renal colic), and potential better understanding of nephrolithiasis (family history, older age on presentation) were more likely to complete a 24-hour urine. Those patients with public insurance/government assistance were less likely to complete a 24-hour urine. These results can be used to develop strategies to improve pediatric patients' adherence to completing 24-hour urine collections.
Urology. 2019 Feb 20 [Epub ahead of print]
Albert S Lee, Laura McGarry, Diana K Bowen, Gregory E Tasian
Department of Urology, Einstein Healthcare Network, Philadelphia, PA 19141., Division of Urology, Ann and Robert H Lurie Children's Hospital of Chicago, Chicago, IL 60611; Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL 60611., Department of Surgery, Division of Pediatric Urology, The Children's Hospital of Philadelphia, Philadelphia, PA 19104; Department of Surgery, Division of Urology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104; Department of Biostatistics, Epidemiology, and Informatics Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104; Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104; Center for Pediatric Clinical Effectiveness, The Children's Hospital of Philadelphia, Philadelphia, PA 19104. Electronic address: .