Impacts of percutaneous nephrolithotomy on the estimated glomerular filtration rate during the first few days after surgery

Long-term effects of percutaneous nephrolithotomy (PCNL) on renal function have been evaluated in many studies but there are little data on the renal effects of PCNL immediately after surgery in human patients. The aim of this study was to evaluate estimated glomerular filtration rate (GFR) during the first few days after PCNL. From July to September 2008, we gathered preoperative and postoperative serum creatinine data of all the patients who underwent PCNL at our center. Children and patients who received transfusion during surgery were excluded. Creatinine clearance was estimated by Cockcroft-Gault equation and was used to estimate GFR. 94 patients met the inclusion criteria. The mean ± SD of creatinine clearance by Cockcroft-Gault equation was 87.5 ± 32.2 cc/min before operation. It decreased to 85.5 ± 29.4 cc/min, 77.0 ± 26.8 cc/min and 75.9 ± 25.0 cc/min at 6, 24 and 48 h after operation and then increased slightly to 81.9 ± 26.4 cc/min 72 h after operation. Renal GFR decreases immediately after PCNL reaches a nadir 48 h after operation, and then, increases slowly. It seems advisable to avoid factors that can bear a negative influence on renal function during the early postoperative period such as nephrotoxic drugs, contrast agents, shock wave lithotripsy and Re-PCNL.