Increased Nephrolithiasis Prevalence in People with Disabilities: A National Health and Nutrition Survey Analysis

Abstract

ObjectiveTo estimate the prevalence of nephrolithiasis in people with disabilities (PWD), while accounting for known kidney stone disease risk factors. MethodsWe used answers to the disability and kidney disease questionnaires from the 2013 to 2016 cycles of the National Health and Nutrition Examination Survey, a nationally representative cross-sectional survey by the Centers for Disease Control, to calculate nephrolithiasis prevalence by functional disability type. We additionally estimated the total US population of stone formers with disabilities and compared disability prevalence between stone formers and non-stone formers. Multivariate logistic regression models were built using known correlates of nephrolithiasis. Results34.7% (CI: 30.5%-39.1%) of United States stone-formers are PWD. The prevalence of nephrolithiasis in PWD is 16.1% (CI: 14.4-18.0) in comparison to 9.2% (CI: 8.3-10.3) in people without disabilities. PWD have significantly elevated odds of nephrolithiasis (un-adjusted OR: 1.91 CI: 1.55-2.36). Adjusting for age, gender, race, diabetes, hypertension, and obesity, odds of nephrolithiasis remain elevated in PWD overall (adjusted OR: 1.46 95% CI: 1.17-1.83) and in all disability domains. ConclusionOne in 3 people with nephrolithiasis are PWD. Odds of nephrolithiasis are increased in PWD even after adjustment for multiple known risk factors in all disability domains. PWD are known to be a unique population that can face significant health disparities, but there is a dearth of studies that estimate urologic disease prevalence within this group. Future urologic research should incorporate disability status to explore potential disparities.