Complications from Kidney Stone Treatment Can be Costly

A new study reveals that one in seven patients receiving treatment for kidney stone experience complications that can prove costly.

Researchers at Duke Medicine found that despite the overall low risk, one in seven receiving treatment for kidney stone experience severe complications that require either hospitalization or emergency care. These complications turn out to be pretty costly. Patients who make an unplanned visit to the hospital spend on an average $30,000. This cost varies based on the kind of procedure and care received.

"Our findings provide a good starting point to understand why these complications are happening and how they can be prevented, because the costs to patients who suffer complications and to the health care system are substantial," said lead author Charles D. Scales Jr., M.D., assistant professor of surgery at Duke.

The conclusion was based on the study that analyzed the outcomes of over 93,000 privately insured patients who received treatment for kidney stones. Treatment offered included procedures like shock wave lithotripsy, ureteroscopy or percutaneous nephrolithotomy.  These are the main interventions that make up approximately $10 billion in annual tabs for kidney stone diseases in the U.S.

The researchers also considered visits to emergency department or hospital admissions that were made within 30 days of original procedure.

Kidney stones also called as renal lithiasis are nothing but small hard deposits that form within the kidneys.  They affect part of the urinary tract. Stones are mostly formed when urine gets concentrated permitting the minerals to crystallize and bind together. Though kidney stones may occur at any age they are most common in adults of  40 and older and generally develop in men.

On analyzing the data the researchers noticed that people who underwent a surgery at a hospital that involved high volume of procedure were less likely to report any complications.

Among those who experienced complications, it was least common after shock wave lithotripsy, it affected nearly 12 percent of patients. People who received ureteroscopy, listed as the second most common procedure, made more unplanned visits. This affected a total of 15 percent of patients. Higher costs of emergency visits were linked with shock lithotripsy i.e. more than $32,000.

The highest cost for complications was amongst those receiving nephrolithotomy, which costs  $47,000 on an average.

"From the patient perspective, an unplanned emergency department visit or hospital admission after a low-risk ambulatory procedure is a significant event," Scales said. "Kidney stones are excruciatingly painful and primarily affect people who are of working age. These patients face not only the cost of treatment, but also the financial difficulties from time off work due to pain and treatment."

Further research is needed to understand why different procedures produced different complication rates. 

"Reducing unplanned emergency visits and hospitalizations associated with kidney stone treatments could result in significant cost savings if the causes can be identified and addressed," Scales said.

The finding was documented in the journal Surgery.