The Impact of Percutaneous Nephrolithotomy in Patients with Chronic Kidney Disease

Kurien, Abraham; Baishya, Ramen Kumar; Mishra, Shashikant; Ganpule, Arvind; Muthu, Veeramani; Sabnis, Ravindra; Desai, Mahesh

doi:10.1089/end.2009.0339

Cited by 37 publications

(32 citation statements)

References 17 publications

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“…Most patients had stage 3 or 4 CKD and most showed improvement or stabilization in renal function after PCNL. Postoperative complications and peak eGFR were the main factors predicting deterioration of kidney function during follow-up [35] . In another study, Bilen et al [36] evaluated 185 subjects with eGFR < 60 mL/min per 1.73 m² undergoing PCNL and found the average preoperative eGFR substantially improved from 42.4 to 48.4 at three months followup.…”

Section: Retrograde Intrarenal Surgerymentioning

confidence: 97%

“…The most common are hypotermia, bleeding, metabolic acidosis, serum electrolytes disturbances, urosepsis, and rarely death [39] . Anemia and underlying platelet dysfunction in patients with CKD may play important role in the high rate of transfusion [35,36] .…”

Section: Percutaneous Nephrolithotomymentioning

confidence: 99%

“…Factors predicting impairment in kidney function were proteinuria > 300 mg/d, cortical atrophy, recurrent UTI, stone burden > 1500 mm², time passed after surgical intervention < 15 years, and pediatric age group [34] . In another study, Kurien et al [35] studied 91 adult patients with serum creatinine level greater than 1.5 mg/dL who performed PCNL. Most patients had stage 3 or 4 CKD and most showed improvement or stabilization in renal function after PCNL.…”

Section: Retrograde Intrarenal Surgerymentioning

confidence: 99%

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Effect of urinary stone disease and its treatment on renal function

Mercimek

Özden

2015

WJN

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Urolithiasis is a common disease that affects urinary tract in all age groups. Both in adults and in children, stone size, location, renal anatomy, and other factors, can influence the success of treatment modalities. Recently, there has been a great advancement in technology for minimally invasive management of urinary stones.The epoch of open treatment modalities has passed and currently there are much less invasive treatment approaches, such as percutaneous nephrolithotomy, ureteroscopy, shockwave lithotripsy, and retrograde internal Surgery. Furthermore, advancement in imaging technics ensures substantial knowledge that permit physician to decide the most convenient treatment method for the patient. Thus, effective and rapid treatment of urinary tract stones is substantial for the preservation of the renal function. In this review, the effects of the treatment options for urinary stones on renal function have been reviewed. Core tip: In this article, urinary stone disease, treatment options and its effects on renal function are examined. Moreover, in the light of recent publications, effect of treatment options on functional state of the kidney in patients with renal impairment is investigated.Mehmet NM, Ender O. Effect of urinary stone disease and its treatment on renal function. World

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Section: Retrograde Intrarenal Surgerymentioning

confidence: 97%

Section: Percutaneous Nephrolithotomymentioning

confidence: 99%

Section: Retrograde Intrarenal Surgerymentioning

confidence: 99%

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Effect of urinary stone disease and its treatment on renal function

Mercimek

Özden

2015

WJN

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“…Dore et al [15] found that diabetes mellitus was the only systemic disease which had a significant effect on final SFR. Karami et al [16] reported that there is no significant difference (85 vs. 90%, p = 0.45) in the success rate between the patients older than 65 years and younger ones, and another study by Kurien et al [17] revealed that PCNL has an acceptable SFR (84%) in patients with chronic kidney disease. In the study of Resorlu et al [12], the final SFR decreased significantly with an increase in Charlson Comorbidity Index (90.8% in patients with no comorbidities, 95.4% in patients with score 1 and 83.9% in patients with score ≥2, p = 0.049).…”

Section: Discussionmentioning

confidence: 99%

Percutaneous Nephrolithotomy in High-Risk Patients: A Single-Center Experience with More than 350 Cases

Nouralizadeh¹,

Lashay²,

Ziaee³

et al. 2013

Urol Int

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Purpose: To assess the surgical outcomes and peri- and postoperative complications following percutaneous nephrolithotomy (PCNL) in high- and low-risk patients according to the American Society of Anesthesiologists (ASA) score. Materials and Methods: We reviewed the patient records of 2,281 cases older than 18 years who had undergone PCNL in the 3 previous years. The patients were divided into two groups: a low-risk group (ASA score 1, 2: 1,922 cases) and a high-risk group (ASA score 3, 4: 359 cases). Results: Analysis of the location and size of the stone, number and type of access, surgical approach, post-PCNL serum hemoglobin and decrease in glomerular filtration rate revealed no significant difference between the two groups. The stone-free rate was similar in both groups and the hospital stay in the high-risk patients was significantly greater than in the low-risk cases. 95% of low-risk and 91% of high-risk cases had surgical complications compatible with grade ≤II (Clavien system) and overall distribution of different grades of surgical complications was similar between the two groups (p = 0.177). Conclusion: Success rate and surgical complications of PCNL in high-risk patients were comparable to low-risk patients. It seems that PCNL may be a safe and effective procedure even in high-risk patients.

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“…[1][2] Endoscopic procedure like PCNL needs continuous irrigation of fluids for better vision and to wash away stone fragments and blood clots formed. [3] Systemic absorption of irrigation fluids sometimes leads to fluid overload and electrolyte imbalances.…”

Section: Introductionmentioning

confidence: 99%

Is normal saline the best irrigation fluid to be used during percutaneous nephrolithotomy in renal failure patient? A prospective randomized controlled trial

Purkait

Kumar

Bansal

et al. 2016

Turkish Journal of Urology

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Objective: Endoscopic procedures like percutaneous nephrolithotomy (PCNL) needs continuous irrigation for better vision and to wash away stone fragments and blood clots. Systemic absorption of irrigation fluids may lead to fluid overload and electrolyte disequilibrium. Renal failure patients are more prone to these electrolyte disturbances. We have evaluated the outcomes of normal saline as irrigation solution to be used in renal failure patient in comparison to distilled water. Methods:Seventy-six patients with renal calculi were enrolled in this study between September, 2014, and December, 2015. All patients have compromised renal functions (creatinine >1.6 mg/dL). All patients were randomized into two groups as Group A (normal saline irrigation), and Group B (distilled water irrigation). Serum electrolytes, hemogram were measured pre-and post operatively. Results:The mean duration of irrigation was 53.34 min in Group A and 52.80 min in Group B (p=0.12). Serum sodium, potassium and hematocrit levels were changed significantly after the PCNL in Group B (p=0.03, 0.04 and 0.02, respectively). The most significant drop was observed in sodium level (139.21±3.65 vs. 136.20±4.10 mEq/L) in Group B. Though Hemoglobin drop was similar in both groups, there was a significant drop in hematocrit value in Group B (p=0.02). Conclusion:Distilled water is associated with hyponatremia and drop in hematocrit level in renal failure patients. Serum potassium level may be significantly altered during distilled water irrigation. Normal saline is safe for PNCL in renal failure patient and its use should be recommended for this purpose.

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The Impact of Percutaneous Nephrolithotomy in Patients with Chronic Kidney Disease

Abstract: PCNL has a favorable impact in CKD patients with good clearance rates and good renal functional outcome. PCNL in this high-risk CKD population is to be done with care and full understanding of its complications.

Cited by 37 publications

References 17 publications

Effect of urinary stone disease and its treatment on renal function

Effect of urinary stone disease and its treatment on renal function

Percutaneous Nephrolithotomy in High-Risk Patients: A Single-Center Experience with More than 350 Cases

Is normal saline the best irrigation fluid to be used during percutaneous nephrolithotomy in renal failure patient? A prospective randomized controlled trial

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