Evaluation of renal function in patients with a main renal stone larger than 1 cm and perioperative renal functional change in minimally invasive renal stone surgery: a prospective, observational study

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Abstract

Purpose: To compare the perioperative relative renal function and determine predictors of deterioration and recovery of separate renal function in patients with renal stones >10 mm and who underwent mini-percutaneous nephrolithotomy or retrograde intra-renal surgery. Patients and methods: A main stone >10 mm or stones growing, high-risk stone formers and extracorporeal shock-wave lithotripsy-resistant stones were prospectively included in 148 patients. Patients with bilateral renal stones and anatomical deformities were excluded. Renal function was evaluated by estimated glomerular filtration rate, 99m-technetium dimercaptosuccinic acid and 99m-technetium diethylenetriamine pentaacetate prior to intervention and at postoperative 3 months. Logistic regression analyses were performed to find predictors of functional deterioration and recovery. Results: The overall stone-free rate was 85.1 %. A third of patients (53/148, 35.8 %) with renal stones >10 mm showed deterioration of separate renal function. Mean renal function of operative sites showed 58.2 % (36.8 %/63.2 %) of that of contralateral sites in these patients. Abnormal separate renal function showed postoperative recovery in 31 patients (58.5 %). Three cases (5.7 %) showed deterioration of separate renal function despite no presence of remnant stones. Improvement rates of the abnormal separate renal function did not differ according to the type of surgery. The presence of hydronephrosis and three or more stones were significant predictors for renal function deterioration. Female gender and three or more stones were significantly correlated with postoperative recovery. Conclusions: Mini-percutaneous nephrolithotomy or retrograde intra-renal surgery was effective and safe for renal function preservation. Patients with multiple large stones should be considered for candidates of active surgical removal.

Original languageEnglish
Pages (from-to)725-732
Number of pages8
JournalWorld Journal of Urology
Volume34
Issue number5
DOIs
StatePublished - 1 May 2016

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Observational Studies
Prospective Studies
Kidney
Percutaneous Nephrostomy
Technetium Tc 99m Dimercaptosuccinic Acid
Lithotripsy
Hydronephrosis
Technetium
Glomerular Filtration Rate
Shock
Logistic Models
Regression Analysis

Keywords

  • Gadolinium DTPA
  • Kidney calculi
  • Kidney function tests
  • Laser
  • Lithotripsy
  • Nephrostomy
  • Percutaneous
  • Technetium 99m dimercaptosuccinic acid
  • Urolithiasis

Cite this

@article{8878a3ab56da4d199a71f999ba99fd3c,
title = "Evaluation of renal function in patients with a main renal stone larger than 1 cm and perioperative renal functional change in minimally invasive renal stone surgery: a prospective, observational study",
abstract = "Purpose: To compare the perioperative relative renal function and determine predictors of deterioration and recovery of separate renal function in patients with renal stones >10 mm and who underwent mini-percutaneous nephrolithotomy or retrograde intra-renal surgery. Patients and methods: A main stone >10 mm or stones growing, high-risk stone formers and extracorporeal shock-wave lithotripsy-resistant stones were prospectively included in 148 patients. Patients with bilateral renal stones and anatomical deformities were excluded. Renal function was evaluated by estimated glomerular filtration rate, 99m-technetium dimercaptosuccinic acid and 99m-technetium diethylenetriamine pentaacetate prior to intervention and at postoperative 3 months. Logistic regression analyses were performed to find predictors of functional deterioration and recovery. Results: The overall stone-free rate was 85.1 {\%}. A third of patients (53/148, 35.8 {\%}) with renal stones >10 mm showed deterioration of separate renal function. Mean renal function of operative sites showed 58.2 {\%} (36.8 {\%}/63.2 {\%}) of that of contralateral sites in these patients. Abnormal separate renal function showed postoperative recovery in 31 patients (58.5 {\%}). Three cases (5.7 {\%}) showed deterioration of separate renal function despite no presence of remnant stones. Improvement rates of the abnormal separate renal function did not differ according to the type of surgery. The presence of hydronephrosis and three or more stones were significant predictors for renal function deterioration. Female gender and three or more stones were significantly correlated with postoperative recovery. Conclusions: Mini-percutaneous nephrolithotomy or retrograde intra-renal surgery was effective and safe for renal function preservation. Patients with multiple large stones should be considered for candidates of active surgical removal.",
keywords = "Gadolinium DTPA, Kidney calculi, Kidney function tests, Laser, Lithotripsy, Nephrostomy, Percutaneous, Technetium 99m dimercaptosuccinic acid, Urolithiasis",
author = "Songzhe Piao and Park, {Ju Hyun} and Hwancheol Son and Hyeon Jeong and Cho, {Sung Yong}",
year = "2016",
month = "5",
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doi = "10.1007/s00345-015-1653-x",
language = "English",
volume = "34",
pages = "725--732",
journal = "World Journal of Urology",
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TY - JOUR

T1 - Evaluation of renal function in patients with a main renal stone larger than 1 cm and perioperative renal functional change in minimally invasive renal stone surgery

T2 - a prospective, observational study

AU - Piao, Songzhe

AU - Park, Ju Hyun

AU - Son, Hwancheol

AU - Jeong, Hyeon

AU - Cho, Sung Yong

PY - 2016/5/1

Y1 - 2016/5/1

N2 - Purpose: To compare the perioperative relative renal function and determine predictors of deterioration and recovery of separate renal function in patients with renal stones >10 mm and who underwent mini-percutaneous nephrolithotomy or retrograde intra-renal surgery. Patients and methods: A main stone >10 mm or stones growing, high-risk stone formers and extracorporeal shock-wave lithotripsy-resistant stones were prospectively included in 148 patients. Patients with bilateral renal stones and anatomical deformities were excluded. Renal function was evaluated by estimated glomerular filtration rate, 99m-technetium dimercaptosuccinic acid and 99m-technetium diethylenetriamine pentaacetate prior to intervention and at postoperative 3 months. Logistic regression analyses were performed to find predictors of functional deterioration and recovery. Results: The overall stone-free rate was 85.1 %. A third of patients (53/148, 35.8 %) with renal stones >10 mm showed deterioration of separate renal function. Mean renal function of operative sites showed 58.2 % (36.8 %/63.2 %) of that of contralateral sites in these patients. Abnormal separate renal function showed postoperative recovery in 31 patients (58.5 %). Three cases (5.7 %) showed deterioration of separate renal function despite no presence of remnant stones. Improvement rates of the abnormal separate renal function did not differ according to the type of surgery. The presence of hydronephrosis and three or more stones were significant predictors for renal function deterioration. Female gender and three or more stones were significantly correlated with postoperative recovery. Conclusions: Mini-percutaneous nephrolithotomy or retrograde intra-renal surgery was effective and safe for renal function preservation. Patients with multiple large stones should be considered for candidates of active surgical removal.

AB - Purpose: To compare the perioperative relative renal function and determine predictors of deterioration and recovery of separate renal function in patients with renal stones >10 mm and who underwent mini-percutaneous nephrolithotomy or retrograde intra-renal surgery. Patients and methods: A main stone >10 mm or stones growing, high-risk stone formers and extracorporeal shock-wave lithotripsy-resistant stones were prospectively included in 148 patients. Patients with bilateral renal stones and anatomical deformities were excluded. Renal function was evaluated by estimated glomerular filtration rate, 99m-technetium dimercaptosuccinic acid and 99m-technetium diethylenetriamine pentaacetate prior to intervention and at postoperative 3 months. Logistic regression analyses were performed to find predictors of functional deterioration and recovery. Results: The overall stone-free rate was 85.1 %. A third of patients (53/148, 35.8 %) with renal stones >10 mm showed deterioration of separate renal function. Mean renal function of operative sites showed 58.2 % (36.8 %/63.2 %) of that of contralateral sites in these patients. Abnormal separate renal function showed postoperative recovery in 31 patients (58.5 %). Three cases (5.7 %) showed deterioration of separate renal function despite no presence of remnant stones. Improvement rates of the abnormal separate renal function did not differ according to the type of surgery. The presence of hydronephrosis and three or more stones were significant predictors for renal function deterioration. Female gender and three or more stones were significantly correlated with postoperative recovery. Conclusions: Mini-percutaneous nephrolithotomy or retrograde intra-renal surgery was effective and safe for renal function preservation. Patients with multiple large stones should be considered for candidates of active surgical removal.

KW - Gadolinium DTPA

KW - Kidney calculi

KW - Kidney function tests

KW - Laser

KW - Lithotripsy

KW - Nephrostomy

KW - Percutaneous

KW - Technetium 99m dimercaptosuccinic acid

KW - Urolithiasis

UR - http://www.scopus.com/inward/record.url?scp=84938501238&partnerID=8YFLogxK

U2 - 10.1007/s00345-015-1653-x

DO - 10.1007/s00345-015-1653-x

M3 - Article

C2 - 26226940

AN - SCOPUS:84938501238

VL - 34

SP - 725

EP - 732

JO - World Journal of Urology

JF - World Journal of Urology

SN - 0724-4983

IS - 5

ER -