Division of Urology
St. Michael's Hospital, University of Toronto
Incidence and treatment trends for kidney stones in Canada: A population-based cohort study
Michael Ordon1, Andrea Lantz Powers2, Ben H. Chew3, Jason Y. Lee1, Michael D. Kogon1, Sri Sivalingam4, Shubhadip (Shubha) K. De5, Naeem Bhojani6, Sero Andonian7.
1Surgery, University of Toronto, Toronto, ON, Canada; 2Urology, Dalhousie University, Halifax, NS, Canada; 3Urologic Sciences, University of British Columbia, Vancouver, BC, Canada; 4Urology, Cleveland Clinic, Cleveland, OH, United States; 5Surgery, University of Alberta, Edmonton, AB, Canada; 6Surgery, University of Montreal, Montreal, QC, Canada; 7Surgery, McGill University, Montreal, QC, Canada
Canadian Endourology Group.
Introduction: The aim of this study was to assess the incidence of kidney stones, demographics of stone formers and treatment trends in Canada, as no such data exists. This data is important for prevention and resource planning.
Method: 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-December 31, 2018 with an acute care kidney stone event. This was defined as a stone resulting in hospital admission, an ED visit (in select provinces), or stone intervention, specifically shockwave lithotripsy (SWL), ureteroscopy (URS), percutaneous nephrolithotomy (PCNL), stent insertion or nephrostomy tube insertion. Demographics and treatment utilization were reported by year and province.
Results: There were 132,339 acute care kidney stone events, increasing from 20,053 in 2013 to 24,191 in 2018. The median age was 57 (IQR 46-66) and 59.5% were male. Across Canada, the crude rate of hospital admission and stone intervention was 328/100,000 and 539/100,000, respectively. The age and gender standardized rate for intervention was highest in NS and lowest in PEI. The most common intervention across Canada was URS (86.3%) followed by SWL (9.6%) and PCNL (9.1%). The utilization of SWL was highest in Manitoba, NL and British Columbia (BC) and lowest in PEI and Alberta. The utilization of URS was highest across the Maritimes (PEI, New Brunswick & NS) and lowest in BC, NL and Manitoba. (see Table 1 for detailed results)
Conclusion: Our study provides data on the demographics of stone formers and treatment trends. There has been a 21% increase in acute care kidney stone events over 5 years. Across Canada, those presenting to hospital or requiring intervention for a kidney stone are more likely to be male, between the age of 46-66 and undergo URS.
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|Endourology||Incidence and Treatment Trends for Kidney Stones in Canada: A Population-Based Cohort Study||TBD|