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Hormonal and hemodynamic changes during percutaneous nephrolithotomy
1Mersin University Department of Anesthesiology, Turkey. atici@mersin.edu.tr
International Urology and Nephrology
|October 5, 2001
Summary
Percutaneous nephrolithotomy (PCNL) can cause hormonal and hemodynamic shifts, including increased blood pressure and elevated renin, aldosterone, and ACTH levels. Patients may experience hyponatremia and metabolic acidosis during the procedure.
Area of Science:
- Nephrology
- Urology
- Endocrinology
Background:
- Percutaneous nephrolithotomy (PCNL) is a common procedure for kidney stone removal.
- Understanding the physiological responses to PCNL is crucial for patient management.
Purpose of the Study:
- To investigate the hormonal and hemodynamic alterations occurring during PCNL.
- To assess changes in electrolytes, renal function, and stress hormones.
Main Methods:
- Monitoring invasive blood pressure and heart rate in 21 patients undergoing PCNL.
- Measuring serum electrolytes, BUN, creatinine, arterial blood gases, renin, aldosterone, and ACTH before, during, and after the procedure.
Main Results:
- Systolic and diastolic blood pressure significantly increased during PCNL (p < 0.05), while heart rate remained stable.
- Serum sodium, potassium, bicarbonate, and base-excess levels decreased during the procedure (p < 0.001).
- Renin, aldosterone, and ACTH levels significantly increased, indicating a stress response.
Conclusions:
- PCNL is associated with significant hormonal and hemodynamic changes, including a tendency towards hyponatremia and metabolic acidosis.
- Elevated stress hormone levels suggest an invasive impact on the kidney.
- These findings necessitate careful consideration during PCNL procedures.