Patient Characteristics Associated with Completion of 24-hour Urine Analyses Among Children and Adolescents with Nephrolithiasis.
Year of Publication
2019 Feb 20
<p><b>OBJECTIVE: </b>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.</p><p><b>MATERIALS AND METHODS: </b>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.</p><p><b>RESULTS: </b>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.</p><p><b>CONCLUSIONS: </b>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.</p>