Acute kidney injury and percutaneous nephrolithotomy: incidence and predictive factors

Fullá, Juan; Prasanchaimontri, Phornphen; Wright, Harlan I.; Elía, M.; De, Smita; Monga, Manoj; Calle, Juan

doi:10.1007/s00345-021-03874-4

Cited by 5 publications

(10 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In our study, age was comparable between the two groups and did not show significant differences. Although our outcome is compatible with some of the previous data,[ 11 18 20 23 ] the literature is contradictory and inadequate regarding this association. On the one hand, plasma flow rate and renal responses to vasodilating factors are weaker in older patients, reducing the kidney’s adaptive capacity to hemodynamic changes.…”

Section: Discussionsupporting

confidence: 87%

“…[ 10 ] In the current study, among 347 patients who underwent PCNL, 16 (4.61%) were diagnosed with AKI. Although our result is compatible with the prevalence of 4.4% described by Fulla et al .,[ 18 ] a review of the literature revealed higher rates of AKI occurrence. A retrospective observational study on 509 consecutive Indian individuals reported that up to 10% of the patients can develop post-PCNL AKI.…”

Section: Discussionmentioning

confidence: 99%

“…proposed the cutoff point of 10.6 g/dL as a predictor of post-PCNL AKI. [ 18 ] Anemia has been previously demonstrated as an independent risk factor for AKI occurrence, regardless of the type of surgery. [ 31 ]…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Prevalence of acute kidney injury following percutaneous nephrolithotomy

Paymannejad,

Dehghani,

Dehkordi

et al. 2024

Journal of Research in Medical Sciences

View full text Add to dashboard Cite

Background: The objective is to evaluate the prevalence of acute kidney injury (AKI) as an early complication of the percutaneous nephrolithotomy (PCNL) procedure. Materials and Methods: From May 2022 to October 2022, we conducted a retrospective study on patients undergoing PCNL procedures in two of the tertiary medical centers affiliated with Isfahan University of Medical Sciences. Patients’ baseline characteristics, laboratory values, perioperative data, and stone features were documented. AKI was defined either as a ≥0.3 mg/dL increase in the serum creatinine level within 2 days, or a ≥1.5-fold increase in baseline serum creatinine level within 7 days after the operation. Laboratory values were measured 1 day before PCNL and daily thereafter until discharge. Patients were followed 1 week later to detect all of the possible cases of AKI. Results: The final analysis was performed on 347 individuals. AKI developed in 16 (4.61%) cases. The two groups were comparable regarding age (P = 0.887), gender (P = 0.566), and underlying comorbidities including diabetes mellitus (P = 0.577) and hypertension (P = 0.383). The mean body mass index (BMI) (P < 0.001) and both frequency and severity of hydronephrosis (P < 0.001) were significantly different. A higher mean PCNL duration (P < 0.001), period of hospitalization (P < 0.001), and blood loss volume (P < 0.001) were observed in those who developed AKI. Overall, 56.3% (9) of patients in the AKI group and 2.7% (9) in the non-AKI group required the establishment of more than one access tract, during the procedure (P < 0.001). A lower preoperative hemoglobin level was observed in the AKI group (P < 0.001). Those with AKI had significantly larger stones (3.08 ± 0.46 vs. 2.41 ± 0.23 cm, P < 0.001) and higher Hounsfield units (P < 0.001). In addition, in the AKI group, most of the calculi (81.3%, 13) were of staghorn type, whereas in the non-AKI group, calculi were most frequently located in the middle calyx (30.2%, 100), (P < 0.001). Conclusion: The prevalence of post-PCNL AKI is approximately 4.61%. The mean BMI, preoperative hemoglobin level, PCNL duration, intraoperative blood loss volume, and hospitalization period were significantly higher among patients who developed AKI. Those with AKI had significantly larger stones with higher Hounsfield units and more frequently of staghorn type. The two groups were not statistically different regarding age, gender, and presence of comorbidities (hypertension and diabetes mellitus).

show abstract

Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Prevalence of acute kidney injury following percutaneous nephrolithotomy

Paymannejad,

Dehghani,

Dehkordi

et al. 2024

Journal of Research in Medical Sciences

View full text Add to dashboard Cite

show abstract

“…Patients with an upper urinary tract stone often developed acute kidney injury (AKI) after surgery, which might be related to the increased risk of POD. 45 , 46 Unfortunately, we did not measure and compare the postoperative renal function index among various surgeries, including estimated glomerular filtration rate (eGFR), creatinine, and BUN. Therefore, more prospective studies with large samples should be needed to further explore the role of urinary calculi surgery at different sites in the occurrence of POD.…”

Section: Discussionmentioning

confidence: 99%

High ASA Physical Status and Low Serum Uric Acid to Creatinine Ratio are Independent Risk Factors for Postoperative Delirium Among Older Adults Undergoing Urinary Calculi Surgery

Liu

Gao

et al. 2023

CIA

View full text Add to dashboard Cite

Purpose This study was to investigate the incidence and potential predictive factors for postoperative delirium (POD) in older people following urinary calculi surgery, and to establish the corresponding risk stratification score by the significant factors to predict the risk of POD. Patients and Methods We retrospectively analyzed the perioperative data of 195 patients aged 65 or older who underwent elective urinary calculi surgery between September 2020 and September 2022. POD was defined by chart-based method, and the serum uric acid to creatinine (SUA/Cr) ratio as well as neutrophil-to-lymphocyte ratio (NLR) were calculated, respectively. Identification of the risk factors for POD was performed by univariate and multivariate logistic regression analysis. Moreover, the risk stratification score was developed based on the regression coefficients of the associated variables. Results In 195 eligible patients following urinary calculi surgery, the median age was 69 (66–72) and 19 patients ultimately developed POD (9.7%). The results by univariate analysis showed that patients with advanced age, high American Society of Anesthesiologists (ASA) physical status (≥3) and low SUA/Cr ratio (≤3.3) were more likely to develop POD, but dexmedetomidine can significantly decrease the risk of the occurrence of POD. The multivariate analysis further indicated that high ASA physical status (≥3) and low SUA/Cr ratio (≤3.3) were independently associated with POD, and the POD incidence could obviously be elevated with the increase of risk stratification score. Moreover, patients with delirium had longer hospital stays. Conclusion POD is frequent in geriatric patients following urinary calculi surgery (9.7%). The high ASA physical status (≥3) and low SUA/Cr ratio (≤3.3) were effective predictors of POD. The corresponding risk stratification based on these factors could be beneficial to determining patients who are susceptible to POD, and thus better preventing and reducing the occurrence of POD. However, large prospective studies are needed to confirm this finding.

show abstract

“…не было обнаружено значимой связи между продолжительностью операции и риском ОПП. Факторами риска ОПП после ПНЛ выступали исходный уровень Cr больше 1,54 нг/дл и дооперационный уровень гемоглобина менее 10,6 г /дл [57].…”

Section: липокалин связанный с нейтрофильной желатиназой (Neutrophil ...unclassified

New biomarkers of kidney damage and their use in minimally invasive treatment of urolithiasis.

Белый¹,

Клочков²,

Klochkov³

2023

ECU

View full text Add to dashboard Cite

Introduction. The effect of various minimally invasive treatment for kidney stones on renal function has not been sufficiently studied. To assess the specificity, severity, and prognostic significance of renal injury of urolithiasis and its minimally invasive treatment, it is necessary to search for «biomarkers of injury». The concentration of serum urea and creatinine used in routine clinical practice, the glomerular filtration rate change in the later stages of the disease and are functional parameters. Materials and methods. The data were searched in the PubMed, Web of Science, Google Scholar, еLibrary.ru using the following keywords: «acute kidney injury», «KIM-1», «kidney injury molecule 1», «NGAL», «neutrophil gelatinase- associated lipocalin», «L-FABP», «liver-type fatty acid binding protein», «cystatin C», «retrograde intrarenal surgery», «percutaneous nephrolithotomy», «kidney injury urolithiasis», «kidney injury nephrolithiasis». Results. Today new biomarkers have been proposed to detect renal injury at the initial stages. These are neutrophil gelatinase-associated lipocalin (NGAL), cystatin C, kidney injury molecule-1 (KIM-1) and liver-type fatty acid binding protein (L-FABP). The level of NGAL and KIM-1 increases until the serum creatinine level increases and the corresponding histological changes in the renal parenchyma develop. In percutaneous nephrolithotomy, multiple punctures and postoperative bleeding are independent risk factors for deterioration of renal function in the long term, and the large size and high density of stones, staghorn stones, and long duration of intervention are largely associated with the development of acute renal injury in the early postoperative period. Obstructive uropathy affects kidney damage in the postoperative period. The elimination of obstruction leads to a decrease in KIM-1 in urine already in the early postoperative period. The dynamics of biomarker levels suggests that percutaneous nephrolithotomy causes more renal injury than retrograde intrarenal surgery (RIRS). Conclusion. Аny minimally invasive treatment for kidney stones may lead to renal injury, which is not always accompanied by impaired function. The mechanisms of renal injury in various variants of minimally invasive treatment for kidney stones have specific features, and the short-term and long-term consequences are currently not fully determined. Further research evaluating the effect of various minimally invasive methods of urolithiasis treatment on the condition of the renal tubules using modern biomarkers is needed.

show abstract

Acute kidney injury and percutaneous nephrolithotomy: incidence and predictive factors

Cited by 5 publications

References 14 publications

Prevalence of acute kidney injury following percutaneous nephrolithotomy

Prevalence of acute kidney injury following percutaneous nephrolithotomy

High ASA Physical Status and Low Serum Uric Acid to Creatinine Ratio are Independent Risk Factors for Postoperative Delirium Among Older Adults Undergoing Urinary Calculi Surgery

New biomarkers of kidney damage and their use in minimally invasive treatment of urolithiasis.

Contact Info

Product

Resources

About