Fluid Intake Application to Reduce Kidney Stone Risks

Do Different Methods of Educating Patients Regarding Fluid Intake Reduce Kidney Stone Risks?

The purpose of this investigation is to prospectively evaluate the benefit of different methods of educating patients regarding their fluid intake through a readily available daily cellular phone application to improve overall urine output and reduce risk factors for stone recurrence.

Study Overview

• Status: Completed
• Conditions: Kidney Stone
• Intervention / Treatment: Behavioral: iPhone Application; Behavioral: Android Application

Detailed Description

The prevalence of kidney stone disease in the United States is increasing. Recurrence of kidney stone disease has been reported as high as 50% at five years. Urine supersaturation is a predominant factor in the formation of crystallization and stone disease and is dependent on fluid volume. High fluid consumption that dilutes the urine has been shown both in vitro and in clinical studies to reduce the tendency for stone crystallization as well as effectively decrease stone recurrence. As a result, water intake greater than two liters per day is a common initial therapy for prevention of stone disease. However, studies have shown that despite physician counseling most patients are only able to modestly increase their urine volume through fluid intake. This finding may be due to a discrepancy in patient perception of their actual fluid intake and resulting urine volume. The purpose of this investigation is to prospectively evaluate the benefit of different methods of educating patient regarding their fluid intake through a readily available daily cellular phone application to improve overall urine output and reduce risk factors for stone recurrence.

• Study Type: Observational
• Enrollment (Actual): 10

Contacts and Locations

Study Locations

• United States
  • North Carolina
    • Chapel Hill, North Carolina, United States, 27599
      • North Carolina Memorial Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

Participants will be Patients ≥ 18 years old, seen in urology or nephrology clinic with a diagnosis of kidney stone, and had a prior 24-hour urine result with volume less than 2 to 2.5 liters

Description

Inclusion Criteria:

1. Patients ≥ 18 years old
2. Seen in urology or nephrology clinic at UNC with a diagnosis of kidney stone
3. Prior 24-hour urine result with volume less than 2 to 2.5 liters

Exclusion Criteria:

1. Patient without cellular phone capable of utilizing Android / Apple application
2. Patient already using some form of monitoring fluid intake / volume
3. Inability to take fluid by mouth
4. Patient with urinary diversion, chronic diarrhea, bowel diversion or other forms of excessive fluid loss
5. Inability to obtain informed consent
6. Non-English speaking

Study Plan

How is the study designed?

Design Details

• Observational Models: Cohort
• Time Perspectives: Prospective

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
iPhone Application; Participants using an iPhone will download the "waterlogged" application and use this to track daily water intake for 1 week.	Behavioral: iPhone Application; The iPhone application "waterlogged" will be used by participants using and iPhone cellular device. This application will be used to track daily fluid intake for 1 week.
Android Application; Participants using an Android cell phone will download the "water your body" application and use this to track daily water intake for 1 week.	Behavioral: Android Application; The Android application "water my body" will be used by participants using an Android cellular device. This application will be used to track daily fluid intake for 1 week.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
24-hour urine volume	7-10 days from baseline

Secondary Outcome Measures

Outcome Measure	Time Frame
Actual 24-hour urine volume vs. patient perceived urine volume	7-10 days from baseline
Ease and interest in monitoring fluid intake based on survey data	7-10 days from baseline

Other Outcome Measures

Outcome Measure	Time Frame
24-hour urine volume for study participants vs. urine volume for retrospective cohort of previously treated kidney stone patients	7-10 days from baseline

Collaborators and Investigators

• Sponsor: University of North Carolina, Chapel Hill
• Investigators: Principal Investigator: Davis Viprakasit, MD, University of North Carolina, Chapel Hill

Publications and helpful links

General Publications

• Scales CD Jr, Smith AC, Hanley JM, Saigal CS; Urologic Diseases in America Project. Prevalence of kidney stones in the United States. Eur Urol. 2012 Jul;62(1):160-5. doi: 10.1016/j.eururo.2012.03.052. Epub 2012 Mar 31.
• Preminger GM. Renal calculi: pathogenesis, diagnosis, and medical therapy. Semin Nephrol. 1992 Mar;12(2):200-16.
• Pak CY, Sakhaee K, Crowther C, Brinkley L. Evidence justifying a high fluid intake in treatment of nephrolithiasis. Ann Intern Med. 1980 Jul;93(1):36-9. doi: 10.7326/0003-4819-93-1-36.
• Borghi L, Meschi T, Amato F, Briganti A, Novarini A, Giannini A. Urinary volume, water and recurrences in idiopathic calcium nephrolithiasis: a 5-year randomized prospective study. J Urol. 1996 Mar;155(3):839-43.
• Parks JH, Goldfischer ER, Coe FL. Changes in urine volume accomplished by physicians treating nephrolithiasis. J Urol. 2003 Mar;169(3):863-6. doi: 10.1097/01.ju.0000044922.22478.32.

Study record dates

Study Major Dates

• Study Start: July 1, 2013
• Primary Completion (Actual): March 1, 2017
• Study Completion (Actual): March 16, 2017

Study Registration Dates

• First Submitted: August 20, 2013
• First Submitted That Met QC Criteria: August 22, 2013
• First Posted (Estimate): August 23, 2013

Study Record Updates

• Last Update Posted (Actual): March 28, 2017
• Last Update Submitted That Met QC Criteria: March 24, 2017
• Last Verified: March 1, 2017

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Kidney Diseases; Urologic Diseases; Pathological Conditions, Anatomical; Urolithiasis; Urinary Calculi; Calculi; Kidney Calculi; Nephrolithiasis
• Other Study ID Numbers: 13-2453