Survey participation and demographics

Through our survey and ancillary data collection methods, we received a total of 121 responses. After careful review, we identified and excluded one duplicate response from our dataset. Consequently, our final analysis was conducted with a robust sample of 120 participants. The professional distribution of the respondents was as follows: 45 nephrologists, 38 dietitians, 14 patients with kidney stones, 11 urologists, one biologist, and other specialties including one radiologist, one psychiatrist, two trade stakeholders, with the remaining being trainees in related fields (Fig. 1A). The Pareto chart, a bar graph sorted by frequency with a cumulative line graph, is instrumental in identifying critical factors in a process—in this case, the management of kidney stones. It illustrates the distribution of healthcare provider specialties and the proportion of patient participants, highlighting the importance of nephrologists and dietitians. The chart also depicts the distribution of participants across various institutional categories, excluding patients. It underscores the significant role of academic, private, and public institutions in kidney stone management.

Fig. 1

Chart of Pareto containing the individual values represented in descending order by bars, and the cumulative total is represented by the line. The Pareto chart is a bar chart of frequencies sorted by frequency. The highest bars are on the left and includes a line showing the scores produced by adding the heights in order from left to right. This chart is used widely in quality control settings to identify critical factors leading to failure or defects in a process in this case management of kidney stones. (A) Representation of distribution regarding health care providers specialties and proportion of patients participating in the survey, the line of Pareto indicates the importance of 3 critical participants categories involved in the management of kidney stones (nephrologists, dieticians, and patients). (B) Representation of participant’s distribution institution categories declared by the participants (excluding the patients). The line of Pareto indicates the importance of 3 critical institutions are involved in the management of kidney stones (academic, private, and public)

Involvement in kidney stone management

Of the 86 professionals actively involved in kidney stone patient management, the majority (80.6%) see fewer than one patient per month. Approximately 6.3% see between 6 and 10 patients, 7.5% manage 11 to 25 patients, 10% handle 25 to 50 patients, and only three urologists reported managing more than 50 patients per month.

The primary reason cited by 60 participants for not being actively involved in kidney stone patient care was engagement in other types of medical activities. About 25% indicated a lack of experience in this area, and none of the respondents considered kidney stone disease management to be overly complicated or uninteresting.

Adaptation of water intake and patient adherence

A significant finding was the expressed need for adapting the daily volume of water intake for patients, which emerged as a primary consideration in patient care. This aspect, along with other specific questions related to improving kidney stone management and patient compliance, is elaborated in Fig. 2.

Fig. 2

Survey Insights on KSD Management Improvement: Illustrates survey responses on ten specific aspects for enhancing kidney stone management and patient adherence. Key areas include urinary parameter monitoring and patient well-being

Key findings from the surveyDaily water intake

The recommendation to adjust the daily water intake was overwhelmingly supported, with 97.5% of participants (including 93 respondents considering it ‘essential,’ 20 ‘very useful,’ and 4 ‘useful’) acknowledging its significance. Only two respondents were neutral, and one found it unhelpful.

It indicates a universal consensus on the critical role of hydration in KSD management (Fig. 3).

Fig. 3

Detailed Survey Breakdown by Respondent Category: Showcases survey results on ten critical management improvement areas, as perceived by patients (A), urologists (B), dietitians (C), and nephrologists (D). Focuses on the feedback regarding urinary parameters and patient feelings

Dietary advice

The importance of practical dietary advice was recognized by 94.1% of participants, with 83 considering it ‘essential,’ 26 ‘very useful,’ and 4 ‘useful.’ Neutral responses amounted to six, while only one participant found it unhelpful.

It is a high recognition of its importance, but the data might suggest a gap in practical application or patient adherence.

Reminders for water intake

The idea of providing reminders, including the volume of water to drink and specific times for drinking, was regarded as valuable by 88.3% of participants (55 found it ‘essential,’ 38 ‘very useful,’ and 13 ‘useful’). Fourteen participants were neutral, and none found it unhelpful.

Strong support for reminders, indicates the potential effectiveness of digital tools or interventions in improving hydration habits.

Urine color monitoring

Monitoring urine color was considered ‘essential’ by 30 participants, ‘very helpful’ by 57, and ‘useful’ by 15, comprising 85% of the total responses. Only 16 were neutral, and 2 considered it not useful.

Majority view it as a crucial part of self-management, suggesting that patients value simple, visual methods to monitor their condition.

Urine pH monitoring

The utility of urine pH monitoring was acknowledged by 84.3% of respondents (27 found it ‘essential,’ 49 ‘very useful,’ and 25 ‘useful’). There were 19 neutral responses and no negative responses.

Widely acknowledged as valuable, these data reflect an awareness of the importance of biochemical monitoring in KSD.

Urine gravity monitoring

About 65.8% found monitoring urine gravity to be important, with 17 considering it ‘essential,’ 39 ‘very useful,’ and 23 ‘useful.’ Neutral and negative responses were 39 and 2, respectively.

Considered important, but with a notable number of neutral responses, suggesting a need for more education or clarity on its relevance.

24-h Urine volume monitoring

This parameter was deemed important by 79.1% of participants (35 considered it ‘essential,’ 46 ‘very useful,’ and 15 ‘useful’). Twenty-three were neutral, and only one found it unhelpful.

Recognized as important, highlighting the need for comprehensive monitoring in KSD management.

Remote monitoring of urinary parameters

The concept of remote monitoring for urine color, pH, density, and 24-h volume were viewed positively by 65% of participants. Neutral and negative views were held by 39 and 3 participants, respectively.

Positive views indicate an openness to technological solutions in managing KSD, though there is some hesitancy or lack of awareness about its potential.

Fatigue monitoring

Monitoring fatigue was seen as ‘essential’ or ‘very useful’ by 65% of patients, contrasting with the views of healthcare professionals (9% of urologists, 24% of nephrologists, and 52.6% of dietitians). Overall, 58.3% (10 ‘essential,’ 34 ‘very useful,’ and 26 ‘useful’) supported this, with 41 neutral and 9 negative responses.

Varied responses, with patients valuing this more than healthcare professionals. This discrepancy points to a need for a broader understanding of KSD’s systemic effects.

Mood monitoring

The majority (72.5%) considered mood monitoring ‘essential’ [15 participants], ‘very useful’ (35), or ‘useful’ (37). The response was ‘neutral’ for 29 and ‘not useful at all’ for 4. Again, a discrepancy was noted between patients (71% found it ‘very useful’ or ‘essential’) and healthcare professionals (18% of urologists, 28.8% of nephrologists, and 57.8% of dietitians).

Generally seen as important, particularly by patients, emphasizing the need to address the psychological aspects of KSD.

A significant finding was the divergence in perspectives between patients and healthcare professionals, particularly concerning fatigue and wellness monitoring. This highlights a gap in understanding patient experiences and the need for more patient-centric approaches in managing KSD.