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Ecological Momentary Assessment of Factors Associated with Water Intake among Adolescents with Kidney Stone Disease

2018; Lippincott Williams & Wilkins; Volume: 201; Issue: 3 Linguagem: Inglês

10.1016/j.juro.2018.07.064

1527-3792

Gregory E. Tasian, Michelle Ross, Lihai Song, Janet Audrain‐McGovern, Douglas J. Wiebe, Steven Warner, Brittney Henderson, Anisha I. Patel, Susan L. Furth,

Dialysis and Renal Disease Management

No AccessJournal of UrologyPediatric Urology1 Mar 2019Ecological Momentary Assessment of Factors Associated with Water Intake among Adolescents with Kidney Stone Disease Gregory E. Tasian, Michelle Ross, Lihai Song, Janet Audrain-McGovern, Douglas Wiebe, Steven G. Warner, Brittney Henderson, Anisha Patel, and Susan L. Furth Gregory E. TasianGregory E. Tasian *Correspondence: Division of Urology, Children's Hospital of Philadelphia, Wood Center, 3rd Floor, 34th St. and Civic Center Blvd., Philadelphia, Pennsylvania 19104 (telephone: 215-590-0317; email: E-mail Address: [email protected]). Department of Surgery, Division of Pediatric Urology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania Department of Surgery, Division of Urology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania Department of Biostatistics, Epidemiology and Informatics, Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania , Michelle RossMichelle Ross Department of Biostatistics, Epidemiology and Informatics, Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania , Lihai SongLihai Song Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania , Janet Audrain-McGovernJanet Audrain-McGovern Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania , Douglas WiebeDouglas Wiebe Department of Biostatistics, Epidemiology and Informatics, Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania , Steven G. WarnerSteven G. Warner Department of Surgery, Division of Pediatric Urology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania , Brittney HendersonBrittney Henderson Department of Surgery, Division of Pediatric Urology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania , Anisha PatelAnisha Patel Department of Pediatrics, Stanford University, Stanford, California , and Susan L. FurthSusan L. Furth Division of Nephrology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania Department of Biostatistics, Epidemiology and Informatics, Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania View All Author Informationhttps://doi.org/10.1016/j.juro.2018.07.064AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Maintaining high water intake decreases kidney stone recurrence but is difficult to do. Strategies to reduce stone recurrence among adolescents are lacking. We conducted an ecological momentary assessment study to identify factors associated with water intake in adolescents with nephrolithiasis. Materials and Methods: The study population consisted of 15 female and 10 male patients 12 to 18 years old with at least 1 prior kidney stone. For 7 days participants used "smart" bottles to self-monitor water intake and received questionnaires randomly 4 times daily, which were completed in real time on mobile devices. The questionnaires ascertained awareness of water intake volume, awareness of water intake goals, perceived need to drink, access to water, alternative beverage consumption and attitudes toward bathrooms. Linear mixed effects models were fit to estimate the association between momentary responses and daily water intake. Results: During 175 person-days 595 assessments (85%) were completed. Median daily water intake was 1,304 ml (IQR 848–1,832) and 20% of participants met their intake goal for 4 days or more. Unawareness of water intake volume was associated with drinking 690 ml less water per day (p = 0.04). A strong self-perceived need to drink more was associated with drinking 1,954 ml less water each day compared to no self-perceived need to drink more (p <0.01). Unawareness of intake goals was weakly associated with drinking 1,129 ml less water each day (p = 0.1). Access to water, alternative beverage consumption and bathroom aversion were not associated with water intake. Conclusions: Unawareness of water volume consumed and low responsiveness to perceived need to drink more were associated with low water intake. Interventions that help adolescents recognize when and identify how to increase water intake may be effective in decreasing stone recurrence. References 1. : Assessing the risk of incident hypertension and chronic kidney disease after exposure to shock wave lithotripsy and ureteroscopy. Kidney Int 2016; 89: 185. Google Scholar 2. : Prevalence of kidney stones in the United States. Eur Urol 2012; 62: 160. 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The corresponding author certifies that, when applicable, a statement(s) has been included in the manuscript documenting institutional review board, ethics committee or ethical review board study approval; principles of Helsinki Declaration were followed in lieu of formal ethics committee approval; institutional animal care and use committee approval; all human subjects provided written informed consent with guarantees of confidentiality; IRB approved protocol number; animal approved project number. Study received institutional review board approval (14-011343). Supported by Grants K23-DK106428 (GET) and K24-DK078737 (SLF) from the National Institute of Diabetes and Digestive and Kidney Diseases. The National Institutes of Health provided financial support for data management and analysis but had no role in study design, data collection, data analysis, data interpretation or writing of the report. The views expressed in this article are those of the authors and do necessarily represent the official view of the National Institute of Diabetes and Digestive and Kidney Diseases. Hidrate Spark bottles were purchased using grant funds and provided to study participants. There is no financial or consulting relationship between any investigators and Hidrate Spark. © 2019 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byWan J (2019) This Month in Pediatric UrologyJournal of Urology, VOL. 201, NO. 3, (414-414), Online publication date: 1-Mar-2019. Volume 201Issue 3March 2019Page: 606-614Supplementary Materials Advertisement Copyright & Permissions© 2019 by American Urological Association Education and Research, Inc.Keywordsnephrolithiasisadolescentdrinkingbehaviorecological momentary assessmentMetricsAuthor Information Gregory E. Tasian Department of Surgery, Division of Pediatric Urology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania Department of Surgery, Division of Urology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania Department of Biostatistics, Epidemiology and Informatics, Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania *Correspondence: Division of Urology, Children's Hospital of Philadelphia, Wood Center, 3rd Floor, 34th St. and Civic Center Blvd., Philadelphia, Pennsylvania 19104 (telephone: 215-590-0317; email: E-mail Address: [email protected]). More articles by this author Michelle Ross Department of Biostatistics, Epidemiology and Informatics, Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania More articles by this author Lihai Song Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania More articles by this author Janet Audrain-McGovern Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania More articles by this author Douglas Wiebe Department of Biostatistics, Epidemiology and Informatics, Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania More articles by this author Steven G. Warner Department of Surgery, Division of Pediatric Urology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania More articles by this author Brittney Henderson Department of Surgery, Division of Pediatric Urology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania More articles by this author Anisha Patel Department of Pediatrics, Stanford University, Stanford, California More articles by this author Susan L. Furth Division of Nephrology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania Department of Biostatistics, Epidemiology and Informatics, Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania More articles by this author Expand All No direct or indirect commercial incentive associated with publishing this article. The corresponding author certifies that, when applicable, a statement(s) has been included in the manuscript documenting institutional review board, ethics committee or ethical review board study approval; principles of Helsinki Declaration were followed in lieu of formal ethics committee approval; institutional animal care and use committee approval; all human subjects provided written informed consent with guarantees of confidentiality; IRB approved protocol number; animal approved project number. Study received institutional review board approval (14-011343). Supported by Grants K23-DK106428 (GET) and K24-DK078737 (SLF) from the National Institute of Diabetes and Digestive and Kidney Diseases. The National Institutes of Health provided financial support for data management and analysis but had no role in study design, data collection, data analysis, data interpretation or writing of the report. The views expressed in this article are those of the authors and do necessarily represent the official view of the National Institute of Diabetes and Digestive and Kidney Diseases. Hidrate Spark bottles were purchased using grant funds and provided to study participants. There is no financial or consulting relationship between any investigators and Hidrate Spark. Advertisement PDF downloadLoading ...