The following is a summary of “Financial Toxicity of Nephrolithiasis: The First Assessment of the Economic Stresses of Kidney Stone Treatment” published in the December 2022 issue of Urology by Green et al.


For a study, researchers sought to look into the financial toxicity (FT) of treating kidney stones.

They conducted a cross-sectional cohort research using in-person and online cohorts from several institutions of stone formers. The verified COST (COmprehensive Score for financial Toxicity) surveying tool was used to poll participants. Lower values implied higher FT, and the highest score was 44. COST scores between 25 and 14 points were considered “moderate FT,” while scores under <14 were considered “severe FT.” SPSS v28 was used to perform descriptive statistics, X2 tests, T-tests, Spearman correlation, and logistic regression.

A total of 241 people were polled, including 126 in-person respondents and 115 online. A total of 26% experienced severe FT (COST score <14), while 60% of individuals reported at least moderate FT (COST score <26). Those reporting moderate to severe FT were, on average 8 years younger (95%CI = 4, 12) than patients reporting mild FT. A substantial negative association existed between out-of-pocket costs and COST scores, meaning that as out-of-pocket costs rose, COST scores fell (Spearman’s rho =-0.406, P = <.001). In addition, participants with moderate to severe FT tended to miss more days at work (P =.002), and those taking care of them tended to miss more days at work (P =.007) owing to their stone illness.

For most people, FT ranged from mild to severe. Although, as previous research had shown, patients with “moderate FT” use cost-coping strategies (such as rationing medication), and those with “severe FT” had worse health outcomes, urologists needed to be aware of the financial burdens of treatment experienced by such patients receiving kidney stone treatment.

Reference: goldjournal.net/article/S0090-4295(22)00808-1/fulltext