Article

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.

Langue : ANGLAIS