Study design: Retrospective cohort study, using linked, population-based health-care data.
Objectives: To describe the incidence, management and outcomes of surgically treated kidney stones after spinal cord injury (SCI). To evaluate the impact of a past history of kidney stones on the occurrence of kidney stones.
Setting: Ontario, Canada.
Methods: A total of 5121 patients were followed a median of 4 years after an incident SCI (occurring between 2002 and 2011). The primary outcome was surgical intervention for upper tract kidney stones.
Results: In follow-up, 66 patients (1.3%) had 89 episodes of surgically treated kidney stones. Treatments included: ureteroscopic lithotripsy (34%), ureteral stent/percutaneous nephrostomy (30%), shockwave lithotripsy (19%) or percutaneous nephrolithotripsy (17%). Following stone treatment, the 30-day mortality rate was low, and the 30-day admission rate to an intensive care unit was 12%. A history of surgically treated kidney stones before SCI (compared with no such history) was associated with a higher risk of kidney stones after SCI (27 vs 3 per 1000 person-years; adjusted hazard ratio 14.74, 95% confidence interval 5.69-38.22).
Conclusion: During intermediate follow-up after SCI, surgically treated upper tract kidney stones occur in 1.3% of patients. Ureteroscopy with lithotripsy is the most common treatment. A history of surgically managed kidney stones before SCI portends a higher risk of stones after SCI.
Written by:
Welk B, Shariff S, Ordon M, Catharine Craven B, Herschorn S, Garg AX. Are you the author?
Division of Urology, Department of Surgery, Western University, London, Ontario, Canada.
Reference: Spinal Cord. 2013 Mar 12. Epub ahead of print.
doi: 10.1038/sc.2013.15
PubMed Abstract
PMID: 23478669
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