# Harnessing Behavior to Decrease Urinary Stone Disease Morbidity Research Project

> **NIH NIH U01** · CHILDREN'S HOSP OF PHILADELPHIA · 2022 · $689,726

## Abstract

PROJECT SUMMARY
Urinary Stone Disease (USD) is an increasingly prevalent and highly recurrent condition associated with major
morbidity at a rising cost to society. Thus, improved management can significantly reduce its health burden.
Increasing fluid intake is recommended to all USD patients. However, knowledge gaps persist regarding the
impact of fluid therapy in preventing USD recurrence including effectiveness of strategies to achieve and
maintain a high urine volume, and whether such strategies reduce USD recurrence. The Prevention of Urinary
Stones with Hydration (PUSH) study is a randomized clinical trial investigating the impact of increased fluid
intake and increased urine output on the recurrence rate of USD in adults and children. In this study 1,642
participants will be randomized to a control or intervention arm. Participants in both arms receive a “smart water
bottle”. The intervention arm involves an additional program of behavioral interventions, including financial
incentives, structured problem solving, and low touch interventions designed to improve adherence to a
prescribed fluid intake regimen. The primary endpoint is occurrence of a stone event during a two-year
observation period. The PUSH study is in its third year, and due to multiple challenges to recruitment of study
participants, follow-up of participants and data collection have not yet been completed. Additional time is needed
to ensure study completion and to accomplish all study goals. Although ureteral stenting is routinely performed
after urological procedures for USD to mitigate peri-operative complications, stents cause significant patient
discomfort. The causal mechanisms are only partly understood. The STudy to Enhance uNderstanding of sTent-
associated Symptoms (STENTS) is a prospective observational cohort study enrolling adolescents and adults
undergoing ureteroscopic intervention for ureteral and/or renal stones. Participants undergo detailed symptom
assessment using validated questionnaires, a psychosocial assessment, quantitative sensory testing for
evaluation of pain sensitization, and detailed collection of clinical and operative data. Biospecimens (blood and
urine) are being collected for future research. Recruitment to the STENTS study and follow-up of the participants
are expected to be completed on time. However, additional time and resources are needed for analysis of
collected study data. In Aim 1 of this application, the investigators will continue and complete participant
enrollment for the PUSH study, continue biospecimen collection for the NIDDK Repository, analyze the data,
and prepare and submit several planned manuscripts related to the study hypotheses. In Aim 2 of this
applications, the investigators will analyze the data from the STENTS studies, interpret findings, and disseminate
findings through peer reviewed publications.

## Key facts

- **NIH application ID:** 10345287
- **Project number:** 2U01DK110961-06
- **Recipient organization:** CHILDREN'S HOSP OF PHILADELPHIA
- **Principal Investigator:** PETER PHILIP REESE
- **Activity code:** U01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $689,726
- **Award type:** 2
- **Project period:** 2016-09-01 → 2025-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10345287

## Citation

> US National Institutes of Health, RePORTER application 10345287, Harnessing Behavior to Decrease Urinary Stone Disease Morbidity Research Project (2U01DK110961-06). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10345287. Licensed CC0.

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