Current practice patterns of urologists providing nutrition recommendations to patients with kidney stones.
OBJECTIVE
To assess urologists' practice patterns and beliefs about dietary therapy for stone prevention. Dietary therapy is offered to stone formers (SFs) by a subset of urologists. While some may involve a registered dietitian (RD) to provide medical nutrition therapy (MNT), most do not as MNT is Medicare-covered only for diabetes and chronic kidney disease.


METHODS
An investigator-created survey was distributed to assess Endourological Society members' opinions, confidence, and practices regarding nutrition therapy.


RESULTS
Respondents (n=217) practice largely in academic, hospital/clinic, and private settings. Most (82%) felt dietary therapy should be provided regardless of the number of stone events. Most (90%) said the urologist should provide dietary recommendations and more than half (52%) do so for ≥75% of patients (10% provide it for <25%). Time spent with SFs for nutrition varied from ≤4 to ≥10 minutes (31% and 23%) with 64% feeling this to be insufficient time. Of urologists providing counseling, 58% assess their patients' diets. Self-confidence in determining dietary contributors to risk factors and in quantifying intake of foods/nutrients varied (range 45%-82%). Most (76%) said they would like another provider to give recommendations; 23% partner with an RD to do so.


CONCLUSIONS
Urologists are interested in dietary stone prevention, despite the fact that the majority have inadequate time to provide it. We identified areas of educational need, specifically, quantifying patients' intake of certain foods/nutrients and identifying whether stone risk factors are diet related. Urologists' skill gaps are precisely the strengths of RDs, and thus, a partnership between RDs and urologists could be beneficial.
1 Department of Urology, University of Wisconsin School of Medicine and Public Health , Madison, Wisconsin.
Margaret L
ML
Wertheim
Stephen Y
SY
Nakada
Kristina L
KL
Penniston
D000328:Adult; D003376:Counseling; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007669:Kidney Calculi / Q000178:diet therapy* / Q000517:prevention & control*; D008297:Male; D006278:Medicare; D018673:Nutrition Policy; D010353:Patient Education as Topic; D010818:Practice Patterns, Physicians'; D014481:United States; D014572:Urology