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The Impact of Distressed Community Index on Stone Burden, Prevention, and Quality of Life in Patients With Nephrolithiasis.

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Τίτλος: The Impact of Distressed Community Index on Stone Burden, Prevention, and Quality of Life in Patients With Nephrolithiasis.
Συγγραφείς: Kofman R; Alix School of Medicine, Mayo Clinic Arizona, Phoenix, AZ., Keddis MT; Department of Nephrology, Mayo Clinic Arizona, Phoenix, AZ., Bannister Z; Department of Urology, Mayo Clinic Arizona, Phoenix, AZ., Humphreys MR; Department of Urology, Mayo Clinic Arizona, Phoenix, AZ., Stern KL; Department of Urology, Mayo Clinic Arizona, Phoenix, AZ., Cabo J; Department of Urology, Mayo Clinic Arizona, Phoenix, AZ. Electronic address: jackson.j.cabo@vumc.org.
Πηγή: Urology [Urology] 2026 Sep; Vol. 215, pp. 28-33. Date of Electronic Publication: 2026 Jul 15.
Τύπος έκδοσης: Journal Article
Γλώσσα: English
Στοιχεία περιοδικού: Publisher: Elsevier Science Country of Publication: United States NLM ID: 0366151 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1527-9995 (Electronic) Linking ISSN: 00904295 NLM ISO Abbreviation: Urology Subsets: MEDLINE
Imprint Name(s): Publication: New York : Elsevier Science
Original Publication: Ridgewood, N.J., Professional Medical Services Co.
Ιατρικοί όροι (MeSH): Nephrolithiasis*/prevention & control , Nephrolithiasis*/psychology , Nephrolithiasis*/therapy , Healthcare Disparities*/statistics & numerical data , Quality of Life*, Humans ; Female ; Cross-Sectional Studies ; Male ; Middle Aged ; Adult ; Aged
Περίληψη: Objective: To assess the impact of Distressed Communities Index (DCI) on treatment disparities and disease-related quality of life (QoL) in a nationwide sample of patients with nephrolithiasis.
Methods: We performed a nationwide online cross-sectional survey of adult registrants of ResearchMatch with nephrolithiasis. Patients from distressed communities (DCI ≥75) were compared to patients from not distressed communities. Stone burden, prevention recommendations, stone-related QoL (WISQOL), and patient-reported barriers to prevention were compared. Multivariable linear regression was used to evaluate the association between DCI and WISQOL scores, adjusting for demographics, emergency care, and income.
Results: Of the 938 respondents in this cohort, 126 (13.4%) were from distressed communities (DCI ≥75). Individuals from distressed communities had significantly lower WISQOL scores (median WISQOL 83 [IQR 55.7-92] vs 87.5 [IQR 68.8-94.6]; P = .005), were more likely to miss ≥5 workdays due to nephrolithiasis (17.5% vs 8.4%; P = .003) and report barriers to making stone-prevention dietary changes (44.4% vs 29.2%; P<.001), primarily due to cost. On multivariable analysis, after controlling for demographics and emergency care utilization, DCI remained inversely correlated with WISQOL; however, upon the addition of income, this association was attenuated.
Conclusion: In this nationwide study, patients from distressed areas faced additional barriers to stone prevention and lower stone-related QoL, though this relationship was primarily driven by income. These findings suggest that community-level socioeconomic distress associated with disparities among patients with stones and may help urologists tailor more equitable and supportive care strategies.
(Copyright © 2026. Published by Elsevier Inc.)
Competing Interests: Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: K.L.S. serves on the editorial board for Urology, but had no involvement in the peer review of this article and had no access to information regarding its peer review. Full responsibility for the editorial process for this article was delegated to another journal editor. The remaining authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
Entry Date(s): Date Created: 20260715 Date Completed: 20260911 Latest Revision: 20260911
Update Code: 20260912
DOI: 10.1016/j.urology.2026.07.012
PMID: 42456780
Βάση Δεδομένων: MEDLINE
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  Data: The Impact of Distressed Community Index on Stone Burden, Prevention, and Quality of Life in Patients With Nephrolithiasis.
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  Data: &lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Kofman+R%22&quot;&gt;Kofman R&lt;/searchLink&gt;; Alix School of Medicine, Mayo Clinic Arizona, Phoenix, AZ.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Keddis+MT%22&quot;&gt;Keddis MT&lt;/searchLink&gt;; Department of Nephrology, Mayo Clinic Arizona, Phoenix, AZ.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Bannister+Z%22&quot;&gt;Bannister Z&lt;/searchLink&gt;; Department of Urology, Mayo Clinic Arizona, Phoenix, AZ.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Humphreys+MR%22&quot;&gt;Humphreys MR&lt;/searchLink&gt;; Department of Urology, Mayo Clinic Arizona, Phoenix, AZ.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Stern+KL%22&quot;&gt;Stern KL&lt;/searchLink&gt;; Department of Urology, Mayo Clinic Arizona, Phoenix, AZ.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Cabo+J%22&quot;&gt;Cabo J&lt;/searchLink&gt;; Department of Urology, Mayo Clinic Arizona, Phoenix, AZ. Electronic address: jackson.j.cabo@vumc.org.
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  Data: Objective: To assess the impact of Distressed Communities Index (DCI) on treatment disparities and disease-related quality of life (QoL) in a nationwide sample of patients with nephrolithiasis.&lt;br /&gt;Methods: We performed a nationwide online cross-sectional survey of adult registrants of ResearchMatch with nephrolithiasis. Patients from distressed communities (DCI ≥75) were compared to patients from not distressed communities. Stone burden, prevention recommendations, stone-related QoL (WISQOL), and patient-reported barriers to prevention were compared. Multivariable linear regression was used to evaluate the association between DCI and WISQOL scores, adjusting for demographics, emergency care, and income.&lt;br /&gt;Results: Of the 938 respondents in this cohort, 126 (13.4%) were from distressed communities (DCI ≥75). Individuals from distressed communities had significantly lower WISQOL scores (median WISQOL 83 [IQR 55.7-92] vs 87.5 [IQR 68.8-94.6]; P = .005), were more likely to miss ≥5 workdays due to nephrolithiasis (17.5% vs 8.4%; P = .003) and report barriers to making stone-prevention dietary changes (44.4% vs 29.2%; P&amp;lt;.001), primarily due to cost. On multivariable analysis, after controlling for demographics and emergency care utilization, DCI remained inversely correlated with WISQOL; however, upon the addition of income, this association was attenuated.&lt;br /&gt;Conclusion: In this nationwide study, patients from distressed areas faced additional barriers to stone prevention and lower stone-related QoL, though this relationship was primarily driven by income. These findings suggest that community-level socioeconomic distress associated with disparities among patients with stones and may help urologists tailor more equitable and supportive care strategies.&lt;br /&gt; (Copyright &#169; 2026. Published by Elsevier Inc.)
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  Data: Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: K.L.S. serves on the editorial board for Urology, but had no involvement in the peer review of this article and had no access to information regarding its peer review. Full responsibility for the editorial process for this article was delegated to another journal editor. The remaining authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
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