Clinical Assessment of Risk Factors for Renal Atrophy After Percutaneous Nephrolithotomy

Abstract

Background This study explored the risk factors for renal atrophy after percutaneous nephrolithotomy (PCNL), and provides a reference for clinical prevention of renal atrophy after PCNL. Material/Methods According to the inclusion and exclusion criteria, the clinical data of 816 patients who underwent PCNL in our hospital from May 2013 to February 2018 were retrospectively collected. Depending on whether the patient had kidney atrophy, they were divided into a renal atrophy group and a non-renal atrophy group. We collected and analyzed data on patient sex, age, kidney location, duration of disease, stone size, hydronephrosis, renal calculus position (renal ureteral junction or multiple pyelonephritis-associated stones), operation time, intraoperative blood loss, perfusion pressure, and pyonephrosis. The indicators with statistically significant differences were selected and multivariate logistic regression analysis was carried out to determine the risk factors for renal atrophy. Results Among 816 patients, 49 had renal atrophy and the incidence rate was 6.01%. Univariate analysis and multivariate logistic regression analysis showed that independent risk factors for renal atrophy after PCNL were: duration of the disease longer than 12 months (OR=4.216, P=0.003, 95% CI: 1.714, 7.354), perfusion pressure >30 mmHg (OR=3.895, P=0.001, 95% CI: 1.685, 8.912), moderate and severe hydronephrosis (OR=5.122, P<0.001, 95% CI: 1.847, 9.863), stones located at the junction of the renal pelvis (OR=3.787, P=0.001, 95% CI: 1.462, 7.654), stones located in multiple calyces (OR=4.531, P=0.014, 95% CI: 1.764, 8.196), and pyonephrosis (OR=10.143, P<0.001, 95% CI: 2.214, 16.248). Conclusions The main risk factors for renal atrophy after PCNL are: course of disease more than 12 months, moderate and severe hydronephrosis, pyonephrosis, multiple calyceal stones, stones at the junction of the renal pelvis, and intraoperative high perfusion pressure.

Associations of MRI-derived kidney volume, kidney function, body composition and physical performance in ≈38 000 UK Biobank participants: a population-based observational study

“…This may be attributed to the association between kidney volume–related measurements and several risk factors of CKD, such as older age, elevated BP, current smoking, lower eGFR and serum albumin and higher LDL-C. Our findings are in line with those of previous studies that suggested low TKV is associated with lower eGFR [ 12 , 21 , 38 , 39 ]. Although the left kidney has a physiologically larger volume than that of the right kidney [ 51 ], a higher degree of difference may be associated with reduced kidney function due to pathologic conditions that can cause a decrease in the unilateral kidney, such as renal artery stenosis [ 52 ], urinary tract obstruction [ 53 ], kidney stones [ 54 ] or CKD [ 55 ]. As identified in our study, a greater difference in the bilateral kidneys was associated with a reduced eGFR and higher albuminuria.…”

Construction and Analysis of Immune Infiltration-Related ceRNA Network for Kidney Stones

“…A recent study has found that symptomatic patients with kidney stones have an increased risk off chronic kidney disease compared with the risk of normal individuals ( Rule et al, 2009 ). A retrospective clinical study has demonstrated that 6.01% of patients with kidney stones experience renal atrophy 2 years after percutaneous nephrolithotomy; kidney stones lasting more than 12 months and multiple calyces stone are independent risk factors ( Xiangrui et al, 2020 ), indicating the serious outcomes of kidney stones. The underlying mechanisms may be associated with urinary tract obstruction, infection, and crystal-induced injury and fibrosis ( Uribarri, 2020 ).…”