Health-related quality of life in renal stone formers: are we improving?

Abstract

Health-related quality of life (HRQOL) is a multidimensional construct measuring how disease impacts one's life. In the context of nephrolithiasis this is particularly relevant given the active and quiescent phases of the disease which may not correlate with the traditional index of stone free status. Several instruments are now available to objectively measure HRQOL in this population, including the first disease-specific instrument. Therefore, an overview of emerging data on HRQOL is provided that reviews the availability of these tools/instruments and emphasizes patient-centered care and research. The common generic instruments used to measure HRQOL in any population (36-Item Short Form health survey and Patient-Reported Outcomes Measurement Information System) and the only disease-specific instrument developed to measure HRQOL in nephrolithiasis (Wisconsin Stone Quality of Life Questionnaire) are described. Emerging evidence suggests that age and sex influence renal stone formers perception of their HRQOL across a range of dimensions. Several other factors also appear to play a role, such as socioeconomic status, but these have yet to be validated in more than one study or population, and postoperative outcomes measured in terms of HRQOL are almost absent from the literature. Physician-centric outcomes, such as stone status, are no longer the only objective and acceptable measures by which to understand the natural history of nephrolithiasis. Patient-centered approaches through the use of HRQOL are slowly emerging in research and clinical care alike. However, they remain largely in their infancy in these spheres.