Analysis of the effect of percutaneous nephrolithotomy on early renal function in patients with complicated renal calculi

doi:10.3877/cma.j.issn.1674-3253.2020.02.013

Abstract

Abstract:

Objective

To investigate the effect of percutaneous nephrolithotomy on early renal function in patients with complicated renal calculi and to evaluate the risk factors for postoperative renal function deterioration.

Methods

Seventy-seven patients with complicated renal calculi who underwent percutaneous nephrolithotomy in our hospital from January 2017 to August 2018 were divided into Group A (patients with normal renal function, serum creatinine <115 μmol·L^-1) and Group B (Patients with abnormal renal function, serum creatinine ≥115 μmol·L^-1) according to preoperative baseline renal function. Each group was divided into single access tract group (number of access tracts=1) and multiple access tracts group (number of access tracts≥2) according to the number of access tracts. Serum creatinine and other indicators of renal function before and 24 hours after surgery were recorded. At the same time, some factors that may affect the changes of renal function were recorded and evaluated.

Results

In group A, multi-channel patients' postoperative cystatin C levels were higher than those before surgery. The difference was statistically significant (P<0.05). Other indicators remained almost steady (P>0.05). In group B, each index in single access tract patients remained basically stable (P>0.05). The levels of serum creatinine and cystatin C increased significantly after multiple access tracts patients, and the estimated glomerular filtration rate decreased significantly (P<0.05). Independent risk factors leading to deterioration of renal function included preoperative high concentrations of serum creatinine, multiple access tracts, diabetes, and hypertension.

Conclusion

Multiple access tracts PCNL has a significant effect on early renal function in patients with renal insufficiency. Preoperative renal injury, diabetes and hypertension are potential risk factors for renal dysfunction.

Key words: Percutaneous nephrolithotomy, Complex renal calculus, Renal function

Lei Guan, Tusong Hamulati·, Yasheng Anniwaer·, Yalin Song. Analysis of the effect of percutaneous nephrolithotomy on early renal function in patients with complicated renal calculi[J]. Chinese Journal of Endourology(Electronic Edition), 2020, 14(02): 135-139.

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References 19

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组别	例数	性别（例）		年龄（岁，±s）	糖尿病（例）	高血压（例）	术前血肌酐（μmol·L^-1，±s）	单通道（例）	多通道（例）
组别	例数	男	女	年龄（岁，±s）	糖尿病（例）	高血压（例）	术前血肌酐（μmol·L^-1，±s）	单通道（例）	多通道（例）
A组	45	31	14	45±11	5	7	74±15	20	25
B组	32	22	10	49±11	17	20	199±79	21	11
P	?	0.99		0.13	<0.001	<0.001	<0.001	0.07	0.07

组别	例数	性别（例）		年龄（岁，±s）	糖尿病（例）	高血压（例）	术前血肌酐（μmol·L^-1，±s）	单通道（例）	多通道（例）
组别	例数	男	女	年龄（岁，±s）	糖尿病（例）	高血压（例）	术前血肌酐（μmol·L^-1，±s）	单通道（例）	多通道（例）
A组	45	31	14	45±11	5	7	74±15	20	25
B组	32	22	10	49±11	17	20	199±79	21	11
P	?	0.99		0.13	<0.001	<0.001	<0.001	0.07	0.07

?		单通道			多通道
?		SCr（μmol·L^-1）	eGFR[ml·min^-1·（1.73 m²）^-1]	CysC（ng·L^-1）	SCr（μmol·L^-1）	eGFR[ml·min^-1·（1.73m²）^-1]	CysC（ng·L^-1）
A组		?	?	?	?	?	?
?	术前	78.0±13.5	99.7±19.3	0.83±0.22	71.6±16.0	115.5±32.6	0.80±0.27
?	术后	80.0±22.0	104.8±25.1	0.88±0.23	79.8±25.5	108.9±37.4	0.87±0.3^*
?	P值	0.42	0.21	0.11	0.25	0.19	0.007
B组		?	?	?	?	?	?
?	术前	213.5±91.6	34.5±16.1	2.07±0.84	170.3±36.9	42.5±11.2	1.71±0.1
?	术后	215.3±104.2	35.1±17.2	2.08±0.86	224.2±40.7^*	25.9±8.4^*	1.82±0.11^*
?	P值	0.77	0.61	0.96	<0.001	<0.001	0.006

?		单通道			多通道
?		SCr（μmol·L^-1）	eGFR[ml·min^-1·（1.73 m²）^-1]	CysC（ng·L^-1）	SCr（μmol·L^-1）	eGFR[ml·min^-1·（1.73m²）^-1]	CysC（ng·L^-1）
A组		?	?	?	?	?	?
?	术前	78.0±13.5	99.7±19.3	0.83±0.22	71.6±16.0	115.5±32.6	0.80±0.27
?	术后	80.0±22.0	104.8±25.1	0.88±0.23	79.8±25.5	108.9±37.4	0.87±0.3^*
?	P值	0.42	0.21	0.11	0.25	0.19	0.007
B组		?	?	?	?	?	?
?	术前	213.5±91.6	34.5±16.1	2.07±0.84	170.3±36.9	42.5±11.2	1.71±0.1
?	术后	215.3±104.2	35.1±17.2	2.08±0.86	224.2±40.7^*	25.9±8.4^*	1.82±0.11^*
?	P值	0.77	0.61	0.96	<0.001	<0.001	0.006

?	例数	术前	术后
非糖尿病	55	123.03±11.06	128.73±92.88
糖尿病	22	137.35±13.38	163.8±78.96^*
非高血压	50	108.21±31.39	110.39±60.65
高血压	27	153.87±98.60	176.17±114.20^*

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