Related Experiment Video
Updated: May 14, 2026
07:45
Estimation of Urinary Nanocrystals in Humans using Calcium Fluorophore Labeling and Nanoparticle Tracking Analysis
Published on: February 9, 2021
Insurance status, stone composition, and 24-hour urine composition
Benjamin W Herrick1, Jessica B Wallaert, Brian H Eisner
1Division of Urology, Department of Surgery, Dartmouth Hitchcock Medical Center, Lebanon, NH 03756, USA. benjamin.w.herrick@hitchcock.org
Journal of Endourology
|February 23, 2013
Summary
Patients with state-assisted insurance (SAI) are more likely to form calcium phosphate (CaPhos) kidney stones compared to those with private insurance (PI). This difference is linked to higher urinary risk factors in SAI patients, suggesting potential disparities in care.
Area of Science:
- Nephrology
- Urology
- Public Health
Background:
- Kidney stone formation is influenced by various factors, including socioeconomic status.
- Understanding the link between insurance status and stone composition is crucial for targeted prevention and treatment.
Purpose of the Study:
- To investigate the relationship between socioeconomic status, indicated by insurance type, and kidney stone composition and urinary risk factors.
- To compare patients with state-assisted insurance (SAI) to those with private insurance (PI) regarding stone analysis and metabolic evaluation.
Main Methods:
- Retrospective review of 346 patients undergoing metabolic evaluation for nephrolithiasis.
- Comparison of stone composition and 24-hour urinary risk factors between SAI and PI groups.
- Multivariate analyses were conducted to adjust for known stone risk factors.
Main Results:
- SAI patients were younger, more likely to be female, and had a significantly higher likelihood of forming calcium phosphate (CaPhos) stones compared to calcium oxalate (CaOx) stones (OR 10.2, p<0.001).
- SAI patients exhibited higher urine sodium, pH, and CaPhos supersaturation, alongside lower uric acid supersaturation.
- Private insurance (PI) patients were significantly less likely to form CaPhos stones (10.1%) compared to CaOx stones (77.4%).
Conclusions:
- State-assisted insurance (SAI) is associated with a higher prevalence of calcium phosphate (CaPhos) kidney stones.
- Increased urinary risk factors for CaPhos stones in SAI patients suggest potential underlying differences in diet or lifestyle.
- Findings highlight the need for tailored patient counseling and resource allocation based on insurance status and associated risk profiles.
Related Concept Videos
01:29Urine Studies I: Urinalysis
Urinalysis is a widely used diagnostic test that analyzes urine's physical, chemical, and microscopic characteristics. Healthcare providers use it to detect and monitor various health conditions, including renal disease, urinary tract infections (UTIs), diabetes, and metabolic or systemic disorders.Components of UrinalysisUrinalysis consists of three primary components: physical, chemical, and microscopic examination. Each provides unique insights into the urine sample and, by extension, the...
01:30Urinary Tract Calculi III: Medical Management
The diagnosis of renal calculi involves several imaging techniques, including non-contrast CT scans and ultrasound. These methods help visualize kidney stones, assess their size and location, and detect possible obstructions. Additionally, Measuring urine pH is useful for diagnosing specific stone types, such as struvite (alkaline pH) and uric acid stones (acidic pH). Cystine stones are primarily linked to cystinuria, a genetic condition. A urinalysis helps detect blood in the urine (hematuria)...
01:24Serum Studies: Renal Function Tests
Renal function tests are crucial for assessing kidney health, monitoring disease progression, and evaluating the kidneys' efficiency in waste elimination, fluid balance, and electrolyte regulation. These tests offer critical insights into kidney function, even though routine measurements may appear normal until there is a significant decline in the glomerular filtration rate or GFR. Typically, signs of kidney impairment only become evident when the GFR falls to about 50% of its normal level.
01:28Urinary Tract Calculi V: Nursing Management
AssessmentSubjective Data: Obtain a detailed health history, including any recent or chronic urinary tract infections, periods of immobilization, previous episodes of renal calculi, and medical conditions such as gout, benign prostatic hyperplasia, or hyperparathyroidism. Review the medication history for drugs that may influence stone formation, including allopurinol, analgesics, loop diuretics, or thiazide diuretics. Document the use of long-term indwelling catheters and any past surgical...
01:18Urine: Physical and Chemical Properties
Urine comprises approximately 95% water and 5% solutes. The primary ingredient, apart from water, is urea - a byproduct of the breakdown of amino acids. Other notable components include uric acid, a residue from nucleic acid metabolism, and creatinine, a metabolite from creatine phosphate breakdown in skeletal muscle tissue.
The concentration of these solutes varies, with urea being the most abundant nitrogenous waste product. Other solutes include sodium, chloride, potassium, phosphate,...
The concentration of these solutes varies, with urea being the most abundant nitrogenous waste product. Other solutes include sodium, chloride, potassium, phosphate,...
01:27Urinary Tract Calculi IV: Nutrition Therapy and Prevention
Management of renal calculi focuses on effective strategies like tailored nutrition and hydration therapy. Adjusting diet and fluid intake reduces stone formation and recurrence, making these interventions simple yet powerful in kidney stone prevention and management.Understanding Kidney StonesKidney stones form when calcium, oxalate, uric acid, and cystine concentrate and crystallize in urine. Factors contributing to their formation include genetic predisposition, certain medical conditions,...