To study the prognosis and influencing factors of renal function in patients with pyelonephritis due to stone obstruction after endoscopic lithotripsy.

The data of 124 cases of pyelonephritis caused by calculus obstruction in our hospital from March 2014 to February 2018 were analyzed. 124 cases were treated with endoscopic lithotripsy, the patients were followed up for 2 years to evaluate the prognosis of renal function and its influencing factors after endoscopic lithotripsy.

Preoperative renal GFR level was lower than that after operation,while preoperative serum creatinine level was higher than that after operation. Follow-up results showed that renal function of 70 patientsimproved after operation. 54 patients presented with persistent renal impairment. While there were significant differences in age, hyperuricemia, preoperative GFR, severe hydronephrosis, diabetes mellitus, perirenal infection, C-reactive protein (CRP), procalcitonin(PCT) between the two groups (P<0.05). The results showed that there was no statistical difference in the data of high fever and stone load (P>0.05). Multivariate logistic regression analysis showed that age, preoperative GFR, severe hydronephrosis, perirenal infection and other factors were the independent influencing factors of postoperative renal function in patients with stone obstructive pyonephrosis.

After acute infection control, endoscopic removal of obstructive pyonephrosis stones is safe. Most patients' renal function can be restored after the removal of obstructive pyonephrosis. However, it is difficult to restore renal function in elderly patients, patients with severe renal impairment, severe hydronephrosis and perirenal infection.