UAB Medicine’s departments of urology and nephrology have collaborated to create a kidney stone clinic to reduce patients’ risk of further stone development through education and dietary and medical therapy. The group clinic, which will be conducted in the former patient resource library at The Kirklin Clinic of UAB Hospital, is one of the first such multi-disciplinary clinics in the south. Physicians are encouraged to refer patients to this clinic. Patients may also refer themselves.
Suzanne Bergman, MD, of the UAB Division of Nephrology, and Dean Assimos, MD, Chair of the Department of Urology, are to some extent modeling the clinic based on their observations at the Metabolic Stone Clinic at the University of Wisconsin Hospital.
The clinic is designed to provide an impetus for patients to get involved in their care, because most treatment regimens often call for big lifestyle changes that patients must manage themselves. Assimos notes that kidney stones impart a major economic burden on this county—several billion dollars per year—as well as having a negative impact on quality of life.
“Many patients suffer from recurrent stone events,” Assimos says. “There is high-level evidence that dietary modifications and medical therapy can limit new stone formation. The goals of this clinic will be to help select the best strategy for patients to prevent recurrent stones. It is expected that group interaction will enrich the patient’s experience.”
Bergman, too, recognizes that patients tend to feel more comfortable asking questions in a relaxed, informal group setting.
“Rather than give a patient medicine and just send them home, we will provide an opportunity for patients to share and learn in a guided setting,” Bergman says. “The studies that were done at Wisconsin suggested that patients retained information about their condition, and tended to grasp and follow treatment plans consistently, in this type of clinical setting. Bergman emphasizes that not only will every participant walk away with their own action plan, but also will benefit from participating with a group. They may also become eligible for clinical trials.
The Kidney Stone Group Session participants attend a one-time meeting of six to eight patients whose medical information and treatments will be discussed with both physicians and a nutritionist. Vital signs and blood work will be gathered so that a profile of each is available for discussion during the meeting. Participants will need to collect two 24-hour urine samples for analysis prior to the group session. The group will learn basic knowledge of conditions and treatments from an educational presentation, but nutrition and therapy regimens will be applied individually according to each patient’s history and risk factors.
“In a group ‘round table’ setting, patients can learn a lot, and maybe be inspired to make crucial lifestyle changes, when others share their experiences,” Bergman says. “We may have a patient in the group who was not drinking enough fluid, or another whose job doesn’t allow for them to go the restroom several times in a short time span. Maybe three or four in the group have low citrate. So we will discuss these topics and how they can be resolved with medication plus lifestyle changes. Patients still have the option to see both physicians individually.”
For more information about the kidney stone group sessions, physician referrals, or self referrals, please contact Lisa Harvey in Dr. Assismos’ office, 205-996-2613.