Abstract:

Objective: To assess health related quality of life (HRQOL) in patients with kidney stones and to predict risk factors for reduced HRQOL in the patients by the Chinese version of Wisconsin stone quality of life questionnaire (C-WISQOL). Methods: The patients with renal stones admitted to Peking University People ' s Hospital from July 2020 to June 2021 were prospectively enrolled. The inclusion criteria included the patients with renal stones aged 18-80 years and sufficient Chinese language foundation, and the exclusion criteria included the patients with internal ureteral stents, malignant tumors, sepsis, etc. Demographic data and clinical data related to kidney stones were collected, and the C-WISQOL and the short form 36 health survey (SF-36) questionnaire completed by the patients was recorded. C-WISQOL included four domains (D): emotional impact (D1), social impact (D2), stone-related impact (D3) and vitality impact (D4). Cronbach ' s α coefficient was used to verify the internal consistency of C-WISQOL, Spearman ' s rho coefficient was used to verify the criterion validity between C-WISQOL and SF-36 questionnaire, confirmatory factor analysis was used to verify the structural validity, convergent validity and discrimination validity of C-WISQOL, and univariate and multivariate analyses were used to explore the risk factors leading to the decline of HRQOL in the patients with kidney stones. Results: The study included 307 patients with kidney stones, of whom 212 (69.1%) were male, with a mean age of (51.9±13.5) years, and a mean body mass index (BMI) of (25.4±3.6) kg/m². 160 (52.1%) patients were complicated with metabolic syndrome (MS), 202 (65.8%) had history of calculi, 217 (70.7%) had calculi related symptoms, 53 (17.3%) had bilateral renal calculi, 82 (26.7%) had ureteral calculi, 199 (64.8%) had hydronephrosis, 78 (25.4%) had renal insufficiency, and urinary tract infection (UTI) was found in 168 patients (54.7%) with an average diameter of (15.6±5.9) mm. The mean total score of C-WISQOL questionnaire for all the patients was (94.9±13.7) points, D1 was (27.2±4.2) points, D2 was (23.8±3.7) points, D3 was (27.0±3.6) points, and D4 was (10.1±1.9) points. The Cronbach ' s α coefficient of the total score of C-WISQOL questionnaire was 0.968 and the four dimensions ranged from 0.860 to 0.898. The Spearman' s rho co- efficient between C-WISQOL and SF-36 total score was 0.564, and the Spearman' s rho coefficient between dimensions was 0.684-0.901, indicating that C-WISQOL had good internal consistency and criterion validity. Confirmatory factor analysis showed that C-WISQOL had good structural validity, convergent validity and discrimination validity. Univariate analysis showed that the patients with MS (OR=1.607, P < 0.001), calculi related symptoms (OR=1.268, P < 0.001), bilateral kidney stones (OR=1.900, P < 0.001), combined with ureteral calculi (OR=1.018, P < 0.001), accompanied by hydronephrosis (OR=1.685, P < 0.001), and UTI (OR=1.275, P < 0.001) were risk factors for decreased HRQOL in the patients with kidney stones, and multivariate analysis showed that the patients with MS (OR=1.475, P < 0.001), calculi related symptoms (OR=1.546, P=0.043) and UTI (OR=1.646, P=0.005) were independent risk factors for HRQOL decline in the patients with renal calculi. The t-test results showed that C-WISQOL scores were significantly higher in the patients without MS, stone-related symptoms and UTI than those in the patients with associated risk factors (P < 0.001). Conclusion: C-WISQOL the questionnaire can be used to evaluate the HRQOL of patients with kidney stones with good reliability. The combination of MS, stone-related symptoms and UTI were independent risk factors for HRQOL reduction in the patients with renal stones.

Key words: Chinese version of Wisconsin stone quality of life questionnaire, Kidney calculi, Quality of life, Risk factors