Kidney stone disease, or nephrolithiasis, is a condition that commonly affects people in the United States. Kentucky is part of the “Kidney Stone Belt”, which has the highest prevalence of kidney stones in the United States. As a member of this region, the state of Kentucky must analyze the quality of nephrolithiasis care provided in the state. Although kidney stone formation is a multifactorial process, efforts must be made to provide consistent care that is in accordance with American Urological Association (AUA) guidelines. Our study is a collaborative effort between Kentucky’s two largest academic medical institutions and aims to reveal the inadequacies of our approach to care today.
We completed a retrospective chart review of 429 nephrolithiasis patients of 13 urologists affiliated with two academic medical institutions. Data included aspects of care conducted during the continuum of nephrolithiasis care, and the data was stored in a database. The data was analyzed and stratified by race using the chi-squared test.
The racial breakdown of our patient population, which consisted of 429 patients, included the following: 359 Caucasian, 55 African American (AA), and 15 Other. We noted statistically significant differences between races in the following areas of nephrolithiasis care: kidney stone analysis, orders for 24-hour urine tests, and dietary histories. Although not statistically significant, our entire patient population had little to no documentation of physician-led counseling for nephrolithiasis prevention. Our analysis points to various areas in which patients could benefit from quality improvement measures and adherence to AUA guideline practices.
Guillen, Brianna A.; Nakamura, Fumihiko; Dodd, Brandon; Tejuoso, Ademilola; Johnson, Sarah; Cranford, Will; Wahlstedt, Eric; Harris, Andrew; and Choi, Kellen, "Outcomes of Nephrolithiasis Care by Patient Race: From a Statewide Quality Improvement Collaborative" (2023). MEDI 8127 Scholarly Activities Pre-Clerkship. 50.
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