Login to Access Video or Poster Abstract: MP95-13
Sources of Funding: None

Introduction

Stress may play a role in endocrinologic causes of kidney stones, be a consequence of stones, or both. We sought to determine if stress was correlated with health-related quality of life (HRQOL) in kidney stone patients with a multi-institutional, prospective approach.

Methods

With IRB approval at participating sites, a subset of patients from the North American Stone Quality of Life Consortium were administered the Perceived Stress Scale (PSS-10) and the Wisconsin Stone Quality of Life (WISQOL) questionnaires. Both are validated, but WISQOL is a stone-specific, patient-reported outcome to assess HRQOL. WISQOL total and domain scores were compared with PSS-10 scores. WISQOL and PSS-10 scores were also compared by patients’ stone and symptom statuses.

Results

Patients (n=114; M 56, F 58; age 55±15 y) from 3 centers participated; 78% were white Caucasian, 6% Hispanic/Latino, 11% Asian, and 4% Black/African American. Most (90%) were mixed calcium stone formers. Duration of stone disease varied (mean 10 y; median 4.5 y) as did patients’ estimated number of lifetime stone events (mean 4.6; median 2.0). Among patients with active stone symptoms (27% of sample), total WISQOL and PSS-10 scores were inversely correlated (Pearson correlation coefficient, -0.235; P=0.014), demonstrating that lower HRQOL was associated with more stress. Domain-level analysis revealed that lower HRQOL scores in domains 1 (emotional impact) and 4 (vitality) were also associated with more stress (P=0.011 and 0.0065, respectively). While the WISQOL discriminated patients with stones at survey completion from patients without (P=0.019 for difference in total scores), the PSS-10 did not (P=0.73 for difference in PSS-10 scores). Similarly, the WISQOL distinguished symptomatic patients from asymptomatic (P<0.0001 for difference) while the PSS-10 could not (P=0.46).

Conclusions

The inverse relationship between the PSS-10 and WISQOL showed overall that patients with higher levels of stress had lower HRQOL. Patients with stone-related symptoms scored lower on the WISQOL for emotional impact and vitality than asymptomatic patients and had significantly more stress. Despite the association of stress and lower HRQOL in patients with stones and symptoms, stress alone did not explain the HRQOL differences between these groups. This study showed that stone patients with a lower HRQOL had more stress. A future comparison of stress levels in stone patients compared to non-stone forming controls may help us determine if stress has a reactive or causative role in kidney stone disease.

Funding

None