Cuaj-Canadian Urological Association Journal最新文献

{"title":"Urinary and sexual function do not mediate psychological distress reduction in the PC-PEP randomized controlled trial A secondary mediation analysis.","authors":"Budoor Salman, Nathan K Smith, Gabriela Ilie, Ross Mason, Ricardo A Rendon, Andrea Kokorovic, Cody MacDonald, Nikhilesh Patil, David Bowes, Greg Bailly, Derek Wilke, Eva Abou-Samra, Robert Rutledge","doi":"10.5489/cuaj.9558","DOIUrl":"10.5489/cuaj.9558","url":null,"abstract":"<p><strong>Introduction: </strong>Psychological distress is common among men treated for localized prostate cancer and is often presumed to stem from treatment-related urinary and sexual sequelae. The Prostate Cancer-Patient Empowerment Program (PC-PEP), a six-month, comprehensive, digital intervention, reduces psychological distress and improves patient-reported urinary and sexual function. This secondary analysis tested whether improvements in urinary incontinence, urinary irritative/obstructive symptoms, or sexual function explain PC-PEP's effect on psychological distress.</p><p><strong>Methods: </strong>In a randomized controlled trial, 128 men with localized prostate cancer were assigned to PC-PEP (n=66) or standard care (n=62) for six months. Psychological distress was measured using the Kessler psychological distress scale (K10), and urinary and sexual function were assessed using the expanded prostate cancer index composite (EPIC) at baseline and six months. Mediation models adjusted for age, relationship status, use of medications for anxiety or depression, Charlson comorbidity index, treatment modality, time from randomization to treatment, and baseline K10 and EPIC scores.</p><p><strong>Results: </strong>PC-PEP produced significant improvements in urinary incontinence and urinary irritative/obstructive symptoms across the full cohort and attenuated postoperative declines in sexual function; however, none of these urinary or sexual outcomes mediated the program's effect on psychological distress.</p><p><strong>Conclusions: </strong>While PC-PEP enhances key urinary and postoperative sexual outcomes, these functional gains do not account for its mental health benefits. This challenges the assumption that psychological distress in prostate cancer survivorship is predominantly driven by urinary or sexual sequelae and highlights the importance of addressing broader psychosocial and behavioral determinants of mental health in survivorship care.</p>","PeriodicalId":50613,"journal":{"name":"Cuaj-Canadian Urological Association Journal","volume":"20 10","pages":"E398-E406"},"PeriodicalIF":2.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13660810/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149229343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Authorship trends in urology literature A bibliometric analysis by gender.","authors":"Maya Morcos, Amir-Ali Golrokhian-Sani, Cerine Benomar, Marc Morcos, Kiera Liblik, D Robert Siemens","doi":"10.5489/cuaj.9644","DOIUrl":"10.5489/cuaj.9644","url":null,"abstract":"<p><strong>Introduction: </strong>The increasing entry of women into urology underscores the need to evaluate academic representation and characterize ongoing disparities within the specialty. This study provides a comprehensive global assessment of gender representation in urologic literature over time by study design, journal type, and geographic region.</p><p><strong>Methods: </strong>All PubMed database abstracts under \"Urology\"[MeSH] or \"Urology\" (January 2002 to January 2024) were evaluated. Authorship position, institutional affiliation country, and journal name were extracted. Descriptive statistics and inferential tests were performed to assess gender-based differences in publication characteristics through validated name-to-gender matching tools.</p><p><strong>Results: </strong>A total of 130 621 publications comprising 885 343 author names were included, of which 21.7% were identified as women. The proportion of women authors increased significantly from 11.4% in 2002 to 26.3% in 2024 (p<0.001). Overall, the number of women in senior authorship positions (14.8%) remains lower than in first-authorship roles (21.6%). The lowest representation of overall women authors was from African institutions (15.3%), whereas the highest was from European institutions (27.3%). Women published less proportionally than men across all study designs, particularly in interventional research (18.5%) and case reports (17.2%). First and senior women authors had higher odds of publishing in predatory journals compared with non-predatory journals (adjusted odds ratio (AOR) 1.18, 95% confidence interval (CI): 1.12-1.24; AOR 1.21, 95% CI 1.14-1.28, respectively).</p><p><strong>Conclusions: </strong>Despite progress, substantial gender disparities persist in authorship in urology research, particularly in senior authorship roles. This global bibliometric analysis highlights the need to better understand the barriers that limit female representation in urologic publications.</p>","PeriodicalId":50613,"journal":{"name":"Cuaj-Canadian Urological Association Journal","volume":"20 10","pages":"356-363"},"PeriodicalIF":2.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13660836/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149229256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of equipment whiteboard checklists in improving communication while reducing case cost during ureteroscopy.","authors":"Kaiden Jobin, Mark A Assmus","doi":"10.5489/cuaj.9581","DOIUrl":"10.5489/cuaj.9581","url":null,"abstract":"<p><strong>Introduction: </strong>Effective communication is essential in operating room (OR) settings to reduce interruptions, ensure patient safety, and reduce equipment-related waste. In the setting of percutaneous nephrolithotomy equipment, whiteboards improved OR staff perceptions of communication and decreased procedural costs. Given that ureteroscopy has varying equipment needs from case to case, we sought to evaluate the effectiveness of equipment whiteboard implementation in ureteroscopy.</p><p><strong>Methods: </strong>Thirty-three urology OR staff were recruited to complete questionnaires assessing confidence in equipment accuracy and efficacy of communication both with and without the equipment whiteboard. Furthermore, 50 cases were randomly allocated 1:1 into having the surgeon verbally indicate equipment needs compared to using the whiteboard. These procedures were assessed for objective accuracy of equipment, case length, case cost, and number of interruptions. All outcomes were compared between groups using two-sided T-tests and Fisher's exact tests.</p><p><strong>Results: </strong>From the questionnaires, we found significant increases with the whiteboard in confidence equipment was in the room (p<0.001, confidence interval [CI] -5.386, -3.621), confidence required equipment was opened (p<0.001, CI -4.956, -3.015), and confidence nothing unnecessary was opened (p<0.001, CI -5.432, -3.393). Furthermore, we found significant improvements in objective equipment accuracy scores (p<0.001, CI -3.982, -1.618), a significant reduction in interruptions (p=0.001, CI -1.147, -0.293), and an average 25% decrease in equipment-related procedural costs (p=0.018, CI 30.661, 313.099).</p><p><strong>Conclusions: </strong>Implementation of an equipment whiteboard for ureteroscopy was effective for improving OR staff confidence in equipment choices and perceptions of communication. Furthermore, the whiteboard improved equipment accuracy while reducing interruptions and procedural costs.</p>","PeriodicalId":50613,"journal":{"name":"Cuaj-Canadian Urological Association Journal","volume":"20 10","pages":"E386-E392"},"PeriodicalIF":2.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13660837/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149229359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk of post-vasectomy infection using non-sterile gloves A retrospective audit of 4785 office-based procedures.","authors":"Jean-Philippe Bercier, Valérie Dumais, Daniel Trottier, Mélanie Savard-Côté, Michel Labrecque","doi":"10.5489/cuaj.9603","DOIUrl":"10.5489/cuaj.9603","url":null,"abstract":"<p><strong>Introduction: </strong>The use of sterile gloves in minor outpatient procedures, including vasectomy, remains debated. Performing vasectomies without sterile gloves may lower costs, shorten operative time, and reduce medical waste-important factors for efficiency and sustainability in high-volume practices. We evaluated the risk of post-vasectomy infection in a large cohort of patients who underwent no-scalpel vasectomy performed without sterile gloves.</p><p><strong>Methods: </strong>We conducted a retrospective review of all vasectomies performed by four physicians using non-sterile gloves from January 1, 2024, to March 31, 2025, across four Canadian outpatient clinics. Infection was defined as an antibiotic prescription within 30 days post-vasectomy recorded in the electronic medical record. We also assessed the effect of attending physician, use of skin glue for wound closure, and appointment duration. Differences were analyzed using Fisher's exact test, with Bonferroni-corrected significance set at p<0.017.</p><p><strong>Results: </strong>Among 4785 vasectomies, four patients (0.08%, 95% confidence interval [CI] 0.03- 0.2%) received antibiotics. No significant differences in infection risks were found between physicians (0.08% [2/3, 798], 0.13% [1/756], 0.93% [1/107], 0% [0/124]; p=0.07). Risks were also similar with vs. without skin glue (0.03% vs. 0.3%, p=0.04) and with short (<15 minutes) vs. longer (>30 minutes) appointment durations (0.07% vs. 0.4%, p=0.18).</p><p><strong>Conclusions: </strong>Post-vasectomy infection risk with non-sterile gloves was very low. These findings support the use of non-sterile gloves for office-based no-scalpel vasectomy. Multicenter, prospective studies are warranted to confirm these findings across diverse clinical settings. Further research should evaluate additional measures, such as skin glue, to reduce infection risk.</p>","PeriodicalId":50613,"journal":{"name":"Cuaj-Canadian Urological Association Journal","volume":"20 10","pages":"E393-E397"},"PeriodicalIF":2.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13660826/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149229185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does treatment of non-obstructing nephrolithiasis reduce recurrent urinary tract infections? A prospective, observational trial from the EDGE consortium.","authors":"Connor M Forbes, Karen L Stern, Jamie Finegan, Amy Reed, Gopal Narang, Kevin Wymer, Jonathan Moore, Jonathan Berger, Jonathan Katz, Kimberly Maciolek, Tatsuki Koyama, Aaron Lee, Ben H Chew, Nicole L Miller, Seth K Bechis, Roger L Sur, Ryan S Hsi","doi":"10.5489/cuaj.9741","DOIUrl":"10.5489/cuaj.9741","url":null,"abstract":"<p><strong>Introduction: </strong>Existing studies link kidney stone treatment to reduced recurrent urinary tract infections (UTIs); however, these studies are limited by their retrospective design and/or lack of comparison group. The present study assesses a prospective, observational cohort of patients with recurrent UTIs who selected observation or intervention for management of their non-obstructing kidney stones to assess for impact on UTI recurrence.</p><p><strong>Methods: </strong>From 2020-2025, patients with non-obstructing kidney stones and recurrent UTIs were prospectively enrolled at four centers. After shared decision-making, participants underwent observation or surgical intervention. The primary outcome was UTI recurrence at 12 months post-enrollment, defined as presence of urinary tract symptoms with positive urine culture. The study was powered to detect a 50% reduction in the rate of UTI recurrence between the groups at 12 months.</p><p><strong>Results: </strong>Among 94 patients recruited, followup data at 12 months was available for 21 observation and 46 intervention patients. There were more staghorn stones in the intervention group (15.2% vs. 0%), and the median stone size was larger (13.5 vs. 6 mm). At 12 months, 81% (n=17) in the observation group and 54% (n=25) in the intervention group had a symptomatic UTI recurrence (p=0.06, non-significant). The subgroup (n=17) of stone-free intervention patients had fewer UTI recurrences compared to the observation group (odds ratio 0.12, 95% confidence interval 0.02-0.66). Causation cannot be confirmed due to the observational nature of the study.</p><p><strong>Conclusions: </strong>For patients with recurrent UTIs and stones, surgical intervention is not associated with decreased risk of UTI recurrence at 12 months overall; however, patients who were stone-free after intervention had significantly fewer UTI recurrences on subgroup analysis.</p>","PeriodicalId":50613,"journal":{"name":"Cuaj-Canadian Urological Association Journal","volume":"20 10","pages":"335-341"},"PeriodicalIF":2.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13660807/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149229216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigating kidney cancer outcomes among First Nations adults in Canada, 2006-2015 Followup of the 2006 Canadian Census Health and Environmental Cohort.","authors":"Garima Saini, Megan Lowe, Lisa K Ellison, Brenda Elias, Michael Tjepkema, Angeline Letendre, Alethea Kewayosh, Loraine D Marrett, Amanda J Sheppard","doi":"10.5489/cuaj.9617","DOIUrl":"10.5489/cuaj.9617","url":null,"abstract":"<p><strong>Introduction: </strong>Where reported at a regional level, kidney cancer incidence and mortality rates are disproportionately higher among First Nations people compared to the non-Indigenous population in Canada; however, national-scale reporting has been limited. This study aimed to examine kidney cancer outcomes among First Nations compared to non-Indigenous adults in Canada from 2006-2015.</p><p><strong>Methods: </strong>Data were from the 2006 Canadian Census Health and Environmental Cohort (CanCHEC), which linked census respondents to national cancer and mortality databases. Age-standardized incidence and mortality rates were calculated using the 1960 World Standard Population and stratified by sex, age, and region. Relative risks were estimated using Poisson regression.</p><p><strong>Results: </strong>First Nations adults were diagnosed with 445 kidney cancer cases from 2006-2015 and had nearly twice the incidence rate of kidney cancer compared to non-Indigenous adults (relative risk [RR] 1.99, 95% confidence interval [CI] 1.68-2.35). Incidence rates were also elevated by sex, across age groups, and within certain regions. Mortality rates were higher among First Nations adults across all categories, including all-cause, cancer-specific, and kidney cancer mortality, in both sexes and overall.</p><p><strong>Conclusions: </strong>These findings support concerns raised by First Nations partners about rising kidney cancer incidence and mortality. Interventions targeting risk factors, improved chronic disease management, and access to care are needed. Consistent national data, including stage information, would support better surveillance, early detection, and equitable cancer outcomes.</p>","PeriodicalId":50613,"journal":{"name":"Cuaj-Canadian Urological Association Journal","volume":"20 10","pages":"342-349"},"PeriodicalIF":2.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13660808/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149229250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of urinary tract infections as a predictor of obstruction in women with a history of urethral sling surgery.","authors":"Arushi Wadhwa, Ailsa May Li Gan, James Ross, Duane Hickling","doi":"10.5489/cuaj.9514","DOIUrl":"10.5489/cuaj.9514","url":null,"abstract":"<p><strong>Introduction: </strong>Midurethral sling (MUS) remains a widely used and effective treatment for stress urinary incontinence, although complications such as voiding dysfunction and urinary tract infections (UTIs) may occur. Prior research has shown that up to 60% of women with chronic lower urinary tract symptoms (LUTS) after MUS surgery meet objective criteria for bladder outlet obstruction (BOO). This exploratory study aimed to assess whether UTI burden is associated with the presence of BOO in women with chronic LUTS following MUS. Secondarily, UTI patterns before and after urethral sling excision were descriptively evaluated.</p><p><strong>Methods: </strong>A retrospective chart review was conducted examining women with a history of MUS and persistent LUTS for at least six months at a single tertiary care center. Obstruction was assessed using urodynamic studies according to Blaivas criteria or fluoroscopic evidence. UTIs were defined using a combination of culture-positive results and documented symptomatic episodes. Associations between UTI burden and obstruction were evaluated using exploratory regression analyses, and symptom outcomes were assessed before and after sling lysis.</p><p><strong>Results: </strong>Among 95 patients, 58 (61%) demonstrated urodynamic evidence of obstruction. Across the entire cohort, the median number of UTIs over a two-year period was zero. The proportion of patients with at least one UTI did not differ significantly between obstructed and non-obstructed groups (Fisher's exact test, p=0.80). On exploratory multivariable logistic regression adjusting for age, menopausal status, and diabetes, the association between pre-lysis UTI burden and obstruction was not statistically significant (odds ratio [OR] 1.08, 95% confidence interval [CI] 0.90-1.29, p=0.42). Fifty-seven patients underwent sling lysis. In obstructed patients undergoing lysis, UTI frequency did not change significantly postoperatively (p=0.29), although many patients reported subjective improvement in storage and voiding symptoms.</p><p><strong>Conclusions: </strong>In this exploratory cohort of women with chronic LUTS following MUS, UTI burden was not observed to be associated with the presence of BOO. While sling excision was associated with subjective symptom improvement, changes in UTI frequency were not statistically significant. These findings suggest that UTI history alone may have limited utility as a clinical marker of obstruction and highlight the need for larger, prospective studies with standardized outcome measures.</p>","PeriodicalId":50613,"journal":{"name":"Cuaj-Canadian Urological Association Journal","volume":"20 10","pages":"350-355"},"PeriodicalIF":2.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13660806/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149229205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Building the West Coast urology dynasty.","authors":"S Larry Goldenberg, Andrew E MacNeily","doi":"10.5489/cuaj.10037","DOIUrl":"10.5489/cuaj.10037","url":null,"abstract":"","PeriodicalId":50613,"journal":{"name":"Cuaj-Canadian Urological Association Journal","volume":"20 10","pages":"299-304"},"PeriodicalIF":2.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13660809/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149229193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Minimally invasive surgery via minimally invasive anesthesia Is laryngeal mask airway sufficient for supine percutaneous nephrolithotomy?","authors":"Ziv Savin, Jeannette Mullins, Yuval Elkun, Asher Mandel, Eve Frangopoulos, Vinay Durbhakula, Campbell Vogt, Linda Dayan Rahmani, Aubrey Dibello, Esther Kim, Adam Daniel Geffner, Blair Gallante, William M Atallah, Raj M Parekh, Mantu Gupta","doi":"10.5489/cuaj.9559","DOIUrl":"10.5489/cuaj.9559","url":null,"abstract":"<p><strong>Introduction: </strong>While endotracheal tube (ETT) is the traditional airway modality for percutaneous nephrolithotomy (PCNL), the adoption of supine positioning has opened the door for alternative strategies. Laryngeal mask airway (LMA) offers potential advantages, but its safety profile in supine PCNL remains understudied. This study aimed to compare urologic and anesthesia-related outcomes between LMA and ETT in patients undergoing ultrasound-guided supine PCNL.</p><p><strong>Methods: </strong>In this retrospective study, 206 adult patients undergoing supine PCNL under general anesthesia between March 2023 and June 2024 were analyzed. Patients were grouped by airway modality: LMA (n=156) or ETT (n=50). Exclusion criteria included body mass index (BMI) >35 kg/m², American Society of Anesthesiologists (ASA) score ≥4, chronic obstructive pulmonary disease (COPD), pregnancy, or incomplete data. Urologic outcomes included intraoperative complications, 30-day complications, and postoperative pain. Anesthesia-related outcomes included hemodynamic instability, post-anesthesia care unit (PACU) stay, airway placement/removal times, and anesthesia-related complications. Outcomes were compared between the groups, and multivariable regression and sensitivity analysis were used to adjust for confounders.</p><p><strong>Results: </strong>Overall complications were significantly lower in the LMA group (13% vs. 28%, p=0.01), and LMA was negatively associated with them in univariable analysis (odds ratio [OR] 0.378, 95% confidence interval [CI] 0.174-0.821, p=0.01). LMA use remained independently associated with a reduced risk of overall anesthetic and urologic complications after ad-hoc adjustments for preoperative risk factors, stone characteristics, and intraoperative factors. Airway placement and removal times were shorter in the LMA group; otherwise, no significant differences were observed in anesthesia-related outcomes. No procedures were aborted or converted due to airway complications.</p><p><strong>Conclusions: </strong>In our limited study, LMA seems to be a safe and effective alternative to ETT for airway management in appropriately selected patients undergoing supine PCNL. Prospective, randomized studies are needed to confirm these findings.</p>","PeriodicalId":50613,"journal":{"name":"Cuaj-Canadian Urological Association Journal","volume":"20 10","pages":"E415-E422"},"PeriodicalIF":2.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13660828/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149229182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prescribing patterns and impact of glucagon-like peptide-1 receptor agonists in a kidney transplant evaluation cohort in British Columbia, Canada A single-center experience.","authors":"Hyunwoong Harry Chae, Cindy Luo, David Harriman, Christopher Nguan","doi":"10.5489/cuaj.9689","DOIUrl":"10.5489/cuaj.9689","url":null,"abstract":"<p><strong>Introduction: </strong>Glucagon-like peptide-1 receptor agonists (GLP-1RA) have demonstrated weight loss and cardiometabolic benefits in specific subpopulations. Studies of GLP-1RAs in Canadian end-stage renal disease (ESRD) and kidney transplantation (KT) patients are limited.</p><p><strong>Methods: </strong>This is a retrospective cohort study of patients evaluated for potential KT at the Vancouver General Hospital (VGH) between January 2014 and August 2024. We analyzed prescription patterns, weight changes, and post-transplant outcomes.</p><p><strong>Results: </strong>At evaluation, 63/2789 (2.3%) patients were on a GLP-1RA. The proportion of GLP-1RA users increased from 0% in 2014-2018, to 0.3% (1/366) in 2019, and 8.7% (20/231) in 2024. There was a mean weight change of -1.82 kg (-1.93%, 95% confidence interval [CI] -3.46 to -0.19, p=0.031; n=26) at six months and -2.50 kg (-2.62%, 95% CI -4.47 to -0.52, p=0.016; n=25) at 12 months post-initiation. Twenty-six patients received a KT and had a median followup of 1.14 (interquartile range [IQR] 0.19-1.79) years. Only 11 patients were on a GLP-1RA at one year post-transplant and had available post-transplant outcome data. No significant differences were detected in estimated glomerular filtration rate (eGFR) (67, IQR 65.5-78 vs. 59, IQR 45-75 mL/min/1.73 m², p=0.18), graft failure (0% vs. 4.6%, p=1) and mortality (0% vs. 3.0%, p=1) between GLP-1RA users vs. non-users at one year post-KT.</p><p><strong>Conclusions: </strong>GLP-1RA use in BC's KT evaluation cohort increased since 2019 and was associated with modest weight loss at six and 12 months post-initiation. No significant differences in post-transplant outcomes were detected. This provides preliminary support for GLP-1RAs as a potentially safe weight management strategy for Canadian KT candidates.</p>","PeriodicalId":50613,"journal":{"name":"Cuaj-Canadian Urological Association Journal","volume":"20 10","pages":"E407-E414"},"PeriodicalIF":2.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13660834/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149229242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}