Perceptions of dietary factors promoting and preventing nephrolithiasis: a cross-sectional survey

  • Mathew Q. Fakhoury
  • Barbara Gordon
  • Barbara Shorter
  • Audrey Renson
  • Michael S. Borofsky
  • Matthew R. Cohn
  • Elizabeth Cabezon
  • James S. Wysock
  • Marc A. BjurlinEmail author
Original Article



To assess knowledge of both promoting and preventive dietary factors on nephrolithiasis in a diverse patient population. Precipitating factors of kidney stone disease include diet, lifestyle, socioeconomic status, and race/ethnicity. However, patient awareness of these influences is poorly described.

Materials and methods

A 24-question survey, assessing intake-related risk factors for stone disease, was administered prospectively to 1018 patients. Responses were summarized with frequency and percent. Statistical comparisons were made using a propensity scoring method in order to account for potential confounding variables. Propensity scores were stratified into quintiles. Further analysis with multiple imputation was performed to account for any missing data in the survey. The results of the propensity-adjusted log-binomial regression model are presented as prevalence ratios (PRs) and 95% confidence intervals (CIs).


Respondents demonstrated limited knowledge of nutrient factors that influence stone development. However, most study participants (70.3%) reported a willingness to make lifestyle changes aimed at lowering their risk for stone disease. Respondents reporting previous nephrolithiasis education were less likely to report that diet had no effect on kidney stone formation (PR = 0.795, 95% CI 0.65, 0.96, p = 0.01) The type of physician who counseled the respondent had no association with patient knowledge for stone disease (PR = 0.83, 95% CI 0.63, 1.10, p = 0.2).


Knowledge of diet-related risk factors for nephrolithiasis is limited among this population. Respondents who received prior education appeared to maintain the knowledge of dietary risk for nephrolithiasis. Participants also expressed a willingness to make requisite dietary changes if that information is provided. Given that most stone formers experience a recurrence, these findings highlight the need for more comprehensive patient education strategies on the modifiable risk factors for nephrolithiasis.


Nephrolithiasis Knowledge Dietary Perceptions Promoting Survey 


Author contributions

MQF protocol/project development, manuscript writing/editing, data collection or management, data analysis. BG protocol/project development, Manuscript writing/editing. BS protocol/project development. AR data analysis. MSB manuscript writing/editing. MRC data analysis, data collection or management. EC data collection or management. JSW protocol/project development, manuscript writing/editing, data collection or management, data analysis. MAB protocol/project development, manuscript writing/editing, data collection or management, data analysis.

Compliance with ethical standards

Conflict of interest

Marc Bjurlin served on a speakers’ bureau for Blue Earth Diagnostics and Ultimate Medical Academy. James Wysock disclsoures: Endocare Inc: paid speaker/consultatn. Fortec Medical, Inc.: paid speaker. Genomic Health Inc.: consultant (went to dinner). Intuitive Surgical Inc: consultant (went to dinner). Precision Biopsy, Inc.: consultant. Sonacare, Inc.: consultant/dinner/travel. Tolmar Pharmaceuticals, Inc.: consultant. Boston Scientific: consultant as well (dinner). United Medical Systems (paid speaker). No other authors have disclosures/conflicts of interest.

Institutional review board statement

This study was reviewed and approved by our institution review board.

Informed consent

Patients were not required to give informed consent to the study as it was a voluntary survey. Our institutional board deems the study exempt.

Supplementary material

345_2018_2562_MOESM1_ESM.pdf (287 kb)
Supplementary material 1 (PDF 287 kb)
345_2018_2562_MOESM2_ESM.docx (15 kb)
Supplementary material 2 (DOCX 14 kb)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Mathew Q. Fakhoury
    • 1
  • Barbara Gordon
    • 2
    • 3
  • Barbara Shorter
    • 4
  • Audrey Renson
    • 5
    • 6
  • Michael S. Borofsky
    • 7
  • Matthew R. Cohn
    • 8
  • Elizabeth Cabezon
    • 9
  • James S. Wysock
    • 10
  • Marc A. Bjurlin
    • 11
    Email author
  1. 1.Department of Surgery, Division of UrologyCook County Health and Hospitals SystemChicagoUSA
  2. 2.University of IdahoBoiseUSA
  3. 3.HealthComm SolutionsBoiseUSA
  4. 4.Long Island University and Smith Institute for UrologyNorthwell HealthNew Hyde ParkUSA
  5. 5.Department of Population HealthNYU Langone Hospital-BrooklynBrooklynUSA
  6. 6.Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health PolicyThe City University of New YorkNew YorkUSA
  7. 7.Department of UrologyUniversity of MinnesotaMinneapolisUSA
  8. 8.Weill Cornell Medical CollegeNew YorkUSA
  9. 9.New York Presbyterian QueensFlushingUSA
  10. 10.Department of UrologyNYU Langone HealthNew YorkUSA
  11. 11.Department of UrologyNYU Langone Hospital-BrooklynBrooklynUSA

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