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Ordon M. et al., 2024: Incidence and trends in the treatment of kidney stones in Canada: A population-based cohort study.

Ordon M, Powers AL, Chew BH, Lee JY, Kogon M, Sivalingam S, De S, Bhojani N, Andonian S.
Division of Urology, Department of Surgery, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
Department of Urology, Dalhousie University, Halifax, NS, Canada.
Department of Urologic Sciences, University of British Columbia, Vancouver, BC, Canada.
Glickman Urological Institute, Cleveland Clinic, Cleveland, OH, United States.
Division of Urology, University of Alberta, Edmonton, AB, Canada.
Division of Urology, University of Montreal, Montreal, QC, Canada.
Division of Urology, McGill University, Montreal, QC, Canada.

Abstract

Introduction: Our objective was to assess the incidence of kidney stones requiring acute care, trends in the surgical treatment of stones, and the demographics of stone formers in Canada.

Methods: We conducted a population-based, retrospective cohort study using administrative data from the Canadian Institute for Health Information. We included Canadian residents age >18, outside of Quebec, who presented between January 1, 2013, and December 31, 2018, with a kidney stone episode. This was defined as a kidney stone resulting in hospital admission, emergency department visit, or stone intervention, specifically shockwave lithotripsy (SWL), ureteroscopy (URS), or percutaneous nephrolithotomy (PCNL).

Results: There were 471 824 kidney stone episodes, including 184 373 interventions. The number of kidney stone episode increased from 277/100 000 in 2013 to 290/100 000 in 2018. The median age was 53 (interquartile range 41-65) and 59.9% were male. The crude rate for stone intervention was 877/100 000. The age- and gender-standardized rate for interventions was highest in Nova Scotia and Newfoundland and Labrador and lowest in Prince Edward Island. The most common intervention in Canada was URS (73.5%), followed by SWL (19.8%) and PCNL (6.7%). The percent utilization of SWL was highest in Manitoba, whereas for URS, it was highest in Prince Edward Island and Alberta.

Conclusions: Our study provides the first population-based data on the demographics of stone formers and treatment trends across Canada. There has been a 4.7% increase in kidney stone episodes over the study period. Those presenting to hospital or requiring intervention for a kidney stone are more likely to be male, age 41-65, and undergo URS.

Can Urol Assoc J. 2024 Feb 15. doi: 10.5489/cuaj.8596. Online ahead of print.
PMID: 38381927 FREE ARTICLE

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Comments 1

Peter Alken on Friday, 07 June 2024 11:00

The authors have expanded their previous study (1) on the changes of stone treatment in Ontario to whole Canada except the province of Quebec “due to privacy issues and inability to access their provincial data.”
When speculating about the differences of stone treatment in the provinces the authors suggest that other factors than concomitant diseases like diabetes, adipositas, or hypertension, and drinking habits or preventive measurements are also contributing to the different rates of intervention, “which may include access to operating room time, number of practicing urologists, and financial reimbursement.” That’s probably the only way to explain why the frequency of procedures significantly differs in Manitoba (MB) compared to Prince Edward Island (PEI) (Fig.1). and is not uniformly following the advice of guidelines.

https://www.storzmedical.com/images/blog/Ordon.png
Fig.1 Modified from: Ordon M, et al. Incidence and trends in the treatment of kidney stones in Canada: A population-based cohort study. Can Urol Assoc J. 2024
(1) Ordon, M., Urbach, D., Mamdani, M. et al. A population based study of the changing demographics of patients undergoing definitive treatment for kidney stone disease. J Urol 2015;193:869-74. https://doi.org/10.1016/j.juro.2014.09.096
Peter Alken

The authors have expanded their previous study (1) on the changes of stone treatment in Ontario to whole Canada except the province of Quebec “due to privacy issues and inability to access their provincial data.” When speculating about the differences of stone treatment in the provinces the authors suggest that other factors than concomitant diseases like diabetes, adipositas, or hypertension, and drinking habits or preventive measurements are also contributing to the different rates of intervention, “which may include access to operating room time, number of practicing urologists, and financial reimbursement.” That’s probably the only way to explain why the frequency of procedures significantly differs in Manitoba (MB) compared to Prince Edward Island (PEI) (Fig.1). and is not uniformly following the advice of guidelines.  [img]https://www.storzmedical.com/images/blog/Ordon.png[/img] Fig.1 Modified from: Ordon M, et al. Incidence and trends in the treatment of kidney stones in Canada: A population-based cohort study. Can Urol Assoc J. 2024 (1) Ordon, M., Urbach, D., Mamdani, M. et al. A population based study of the changing demographics of patients undergoing definitive treatment for kidney stone disease. J Urol 2015;193:869-74. https://doi.org/10.1016/j.juro.2014.09.096 Peter Alken
Saturday, 13 July 2024