Effect of tubeless percutaneous nephrolithotomy on early renal function: Does it deteriorate?

Hosseini, Seyed Reza; Mohseni, Mohammad Ghasem; Roshan, Hamzeh; Alizadeh, Farshid

Effect of tubeless percutaneous nephrolithotomy on early renal function: Does it deteriorate?

Authors

¹ Department of Urology, Tehran University of Medical Sciences, Tehran, Iran

² Department of Urology, Kidney Transplantation Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: The impact of standard percutaneous nephrolithotomy (PCNL) on short or long-term renal function has been evaluated in many studies. We evaluated the effect of tubeless PCNL on early renal function.
Materials and Methods: A total of 117 patients referring to our university center for PCNL were enrolled in the study if they were matched with the inclusion criteria. Serum creatinine and hemoglobin (Hb) levels were measured before PCNL and 6, 24, 48, and 72 h after the operation. Glomerular filtration rate (GFR) was calculated using Cockroft-Gault formula.
Results: There were 79 (67.5%) men and 38 women (32.5%) with the mean age of 49.94 years ranging from 18 to 80 years in the study group. The mean creatinine level elevated in the first 48 h after PCNL but it started to reduce on the 3^rd day (mean preoperative creatinine level: 1.32 ± 0.18 mg/dL, mean creatinine level after 48 h: 1.59 ± 0.24 mg/dL, creatinine level after 72 h: 1.42 ± 0.21245 mg/dL) (P < 0.0001). GFR values had the same rise and fall pattern as serum creatinine level (mean preoperative GFR: 74.89 mL/min, mean GFR after 48 h: 64.04 mL/min, GFR after 72 h: 69.54 mL/min, P < 0.0001). PCNL also affected blood Hb level. The mean preoperative Hb level was 15.06 ± 0.87 g/dL and it significantly decreased to 13.09 ± 1.06 g/dL after the operation (P < 0.0005).
Conclusions: Tubeless PCNL like standard PCNL decreases GFR in the very early postoperative days. It is recommended that factors that might have a negative impact on renal function during first few days after PCNL be avoided.

Keywords

References

1.	Bilen CY, Inci K, Kocak B, Tan B, Sarikaya S, Sahin A. Impact of percutaneous nephrolithotomy on estimated glomerular filtration rate in patients with chronic kidney disease. J Endourol 2008;22:895-900.
2.	Chandhoke PS, Albala DM, Clayman RV. Long-term comparison of renal function in patients with solitary kidneys and/or moderate renal insufficiency undergoing extracorporeal shock wave lithotripsy or percutaneous nephrolithotomy. J Urol 1992;147:1226-30.
3.	Handa RK, Matlaga BR, Connors BA, Ying J, Paterson RF, Kuo RL, et al. Acute effects of percutaneous tract dilation on renal function and structure. J Endourol 2006;20:1030-40.
4.	Tok A, Ozturk S, Tepeler A, Tefekli AH, Kazancioglu R, Muslumanoglu AY. The effects of percutaneous nephrolithotomy on renal function in geriatric patients in the early postoperative period. Int Urol Nephrol 2009;41:219-23.
5.	Moskovitz B, Halachmi S, Sopov V, Burbara J, Horev N, Groshar D, et al. Effect of percutaneous nephrolithotripsy on renal function: Assessment with quantitative SPECT of (99m) Tc-DMSA renal scintigraphy. J Endourol 2006;20:102-6.
6.	Samad L, Qureshi S, Zaidi Z. Does percutaneous nephrolithotomy in children cause significant renal scarring? J Pediatr Urol 2007;3:36-9.
7.	Wadhwa P, Aron M, Bal CS, Dhanpatty B, Gupta NP. Critical prospective appraisal of renal morphology and function in children undergoing shockwave lithotripsy and percutaneous nephrolithotomy. J Endourol 2007;21:961-6.
8.	Dawaba MS, Shokeir AA, Hafez A, Shoma AM, El-Sherbiny MT, Mokhtar A, et al. Percutaneous nephrolithotomy in children: Early and late anatomical and functional results. J Urol 2004;172:1078-81.
9.	Chatham JR, Dykes TE, Kennon WG, Schwartz BF. Effect of percutaneous nephrolithotomy on differential renal function as measured by mercaptoacetyl triglycine nuclear renography. Urology 2002;59:522-5.
10.	Nouralizadeh A, Sichani MM, Kashi AH. Impacts of percutaneous nephrolithotomy on the estimated glomerular filtration rate during the first few days after surgery. Urol Res 2011;39:129-33.
11.	Traxer O, Smith TG 3^rd, Pearle MS, Corwin TS, Saboorian H, Cadeddu JA. Renal parenchymal injury after standard and mini percutaneous nephrostolithotomy. J Urol 2001;165:1693-5.
12.	Bayrak O, Seckiner I, Erturhan SM, Mizrak S, Erbagci A. Analysis of changes in the glomerular filtration rate as measured by the cockroft-gault formula in the early period after percutaneous nephrolithotomy. Korean J Urol 2012;53:552-5.

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