MP21-13 LOWER SOCIOECONOMIC STATUS IS ASSOCIATED WITH HIGHER URINARY SODIUM: IMPLICATIONS FOR DIETARY STONE GUIDANCE IN UNDERSERVED COMMUNITIES

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP21-13 LOWER SOCIOECONOMIC STATUS IS ASSOCIATED WITH HIGHER URINARY SODIUM: IMPLICATIONS FOR DIETARY STONE GUIDANCE IN UNDERSERVED COMMUNITIES Wilson Sui, Kevin Chang, Heiko Yang, Kevin Shee, Reuben Sarwal, Rei Unno, Ukrit Rompsaithong, David Bayne, Marshall Stoller, and Tom Chi Wilson SuiWilson Sui More articles by this author , Kevin ChangKevin Chang More articles by this author , Heiko YangHeiko Yang More articles by this author , Kevin SheeKevin Shee More articles by this author , Reuben SarwalReuben Sarwal More articles by this author , Rei UnnoRei Unno More articles by this author , Ukrit RompsaithongUkrit Rompsaithong More articles by this author , David BayneDavid Bayne More articles by this author , Marshall StollerMarshall Stoller More articles by this author , and Tom ChiTom Chi More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003246.13AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Lower socioeconomic status (SES) is associated with higher stone burden at presentation, requiring more frequent and invasive procedures. Unhealthy dietary patterns and impaired access to healthy food in low-income communities are thought to exacerbate this problem. To investigate whether the relationship between SES, diet and stone disease is reflected in 24-hour urine composition, we investigated the associations between 24-hour urine parameters and median income by home zip code in stone patients. METHODS: The Registry for Stones of the Kidney and Ureter was queried for all adult subjects who underwent a 24-hour urine test between 2015 and 2022. A similar number of subjects who were prospectively followed but did not complete 24-hour urine testing were also evaluated. Demographic data including home zip code and clinical characteristics were abstracted for analysis. We then used publicly available zip-code level data from the U.S. Census Bureau to stratify patients into quintiles by median income and 24-hour urine parameters were compared. A multivariable linear regression model was created to identify significant independent predictors among demographic and past medical history characteristics. RESULTS: Of 1,224 subjects who met inclusion criteria, 635 (52%) had undergone 24-hour urine testing. Compared to those in the top quintile, individuals in the bottom quintile of income were younger, more likely to be non-white and had a higher proportion of diabetes (16% vs 9%, p = 0.014), chronic kidney disease (6.2% vs 2.4%, p = 0.038) and chronic obstructive pulmonary disease (5% vs 1.6%, p=0.036). These patients were also less likely to have 24-hour urine testing (42% versus 52%, p=0.004). On comparison of 24-hour urine data, individuals in the bottom quintile of income had higher mean urinary sodium and on multivariable linear regression controlling for demographic and clinical characteristics, lower income remained significantly associated with increased urinary sodium (β = 5.2 ± 2.3, p=0.025). CONCLUSIONS: Lower SES is associated with higher levels of urinary sodium. In addition to reinforcing the need for more epidemiologic investigation and public health intervention, this finding highlights SES as a consideration for tailoring dietary modifications. Source of Funding: none © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e291 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Wilson Sui More articles by this author Kevin Chang More articles by this author Heiko Yang More articles by this author Kevin Shee More articles by this author Reuben Sarwal More articles by this author Rei Unno More articles by this author Ukrit Rompsaithong More articles by this author David Bayne More articles by this author Marshall Stoller More articles by this author Tom Chi More articles by this author Expand All Advertisement PDF downloadLoading ...