Introduction of a Standardized Approach of Electronic Urinary pH Monitoring to Assist Alkalization Therapy: A Uric Acid Urolithiasis Patient's Perspective.

ABSTRACT

Introduction: This study evaluates the introduction of an electronic pH meter to measure the urinary pH in patients with uric acid (UA) urolithiasis and assess patient's perspective. Materials and Methods: Patients known with UA urolithiasis were included in this single-center, nonrandomized, prospective feasibility study, IDEAL stage 2a. Their experience with urolithiasis and satisfaction with the method of urinary pH monitoring before inclusion was evaluated. All patients received an electronic pH meter and standardized instructions. After a period of 6-12 weeks their experience and satisfaction with this pH meter and new regimen was assessed. Patient satisfaction was scored on a Likert scale 1-5. Results: Eighteen patients were included. Median age was 63 years and median body mass index was 30 kg/m2. The cohort consisted of 67% men and 33% women. In their medical history, 55% had unilateral stones, whereas 45% had bilateral stones. The median estimated glomerular filtration rate was 58 mL/minute/1.73 m2. Eighty-nine percent took medication to alkalize their urine, median 3.5 years. Fifteen patients used paper reagent strips and three used an electronic pH meter to assess urinary pH before this study. Satisfaction with the method of urinary pH measurement at inclusion was reasonable (median score 3; interquartile range [IQR] 1-4). Satisfaction with the new electronic pH meter was good (median score 4; IQR 3-5), as was the overall satisfaction (median score 4; IQR 3-5). The new electronic pH meter was slightly easier to use (median 3.5; IQR 1.75-5), as easy in maintenance (median 3; IQR 2-4), and significantly easier to read (median 5; IQR 4-5). The new electronic pH meter was better (median score 4; IQR 2.75-5) than their previous method. Conclusion: The introduction of a standardized approach of urinary pH monitoring for UA urolithiasis patients with an electronic pH meter leads to an easier interpretable outcome and higher patient satisfaction.