Impact of the adherence to medical treatment on the main urinary metabolic disorders in patients with kidney stones

Abstract

Objective To assess the effect of the adherence to medical treatment on urinary parameters in the 24-h metabolic study of patients with kidney stones. Methods A retrospective, longitudinal, descriptive, and observational study was carried out by reviewing the hospital electronic medical record from 2014 to 2018. The adherence to drug treatment was measured 6 months after its initiation, and the numerical values of the metabolic studies were compared. Wilcoxon tests were performed to compare the difference before and after treatment. Results Ninety patients were evaluated, with 73.3% of adherence. The 180-day overall adherence rate was 61.2% in patients treated with a single drug and 85.4% in patients treated with multiple drugs. There is a statistically significant increase in citrate levels in patients with good adherence in comparison with non-adherent patients ( p =0.031 vs. p =0.528). Conclusions Medical treatment and dietary measures in patients with kidney stones have an initial impact at 6 months on the values of the main urinary metabolic alterations that predispose to calculi formation; the most significant is seen in those patients with adherence to medical treatment for hypocitraturia.

Alkaline Water: Help or Hype for Uric Acid and Cystine Urolithiasis?

“…12 Unfortunately, the cumbersome thrice daily treatment regimen, large tablets, gastrointestinal side effects, and cost has led to a longterm adherence rate as low as 61%. 4,11 It is easy to understand that the lay stone-forming public might surmise that drinking an alkaline fluid, with a pH around 10, would cause urinary alkalinization; however, pH of the beverage is only one of the determinants of the physiologic alkali load. At a pH of 10, water will have a hydroxyl (alkali) concentration of 0.1 mEq/L, trivial as compared to the typical daily metabolic acid production of humans, which is in the range of 40 to 100 mEq/d.…”

“…12 Unfortunately, the cumbersome thrice daily treatment regimen, large tablets, gastrointestinal side effects, and cost has led to a long-term adherence rate as low as 61%. 4,11…”

“…10 Due to the frequency of administration, number and size of tablets, cost and side effects, adherence to potassium citrate tablet therapy is challenging for many patients. 11 Finding a more practical, cost-effective approach toward therapeutic measures that can both facilitate an increase in urine pH while increasing fluid intake is of great interest.…”

Gaps in kidney stone disease management: From clinical theory to patient reality

“…The overall adherence rate was 61.2% for those treated with a single drug and 85.4% for those treated with multiple drugs. A significant increase in citrate levels was observed in patients with good adherence compared to non-adherent patients [ 16 ]. It suggests a need for more tailored dietary interventions, possibly involving more frequent and in-depth consultations with dietitians or the use of new technology to provide personalized dietary recommendations.…”

Leveraging behavioral modification technology for the prevention of kidney stones

“…Adherence to kidney stone prevention medical therapy is unfortunately low; about half of patients who are prescribed a medication regimen are nonadherent [11,35]. A common contributor to medication nonadherence in chronic conditions such as USD is forgetfulness [36].…”