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Percutaneous nephrolithotomy in polycystic kidney disease: is it safe and effective?

Aneesh Srivastava1, Rajesh Bansal, Alok Srivastava

  • 1Department of Urology and Renal Transplant, SGPGIMS, Lucknow, India.

International Urology and Nephrology
|November 22, 2011
PubMed

Insights

Percutaneous nephrolithotomy (PCNL) is a safe and effective treatment for kidney stones in patients with autosomal dominant polycystic kidney disease (ADPKD). This procedure offers a high success rate despite anatomical challenges and associated chronic kidney disease.

Area of Science:

  • Nephrology
  • Urology
  • Surgical Innovation

Background:

  • Nephrolithiasis is a common complication in autosomal dominant polycystic kidney disease (ADPKD).
  • Managing kidney stones in ADPKD patients presents unique challenges due to cystic changes and altered renal anatomy.
  • Patients with ADPKD often have comorbid chronic kidney disease, increasing procedural risks.

Purpose of the Study:

  • To evaluate the efficacy and safety of percutaneous nephrolithotomy (PCNL) for treating nephrolithiasis in patients with ADPKD.
  • To assess the outcomes of PCNL in ADPKD patients with varying degrees of chronic kidney disease.

Main Methods:

  • A retrospective analysis of 22 ADPKD patients who underwent PCNL for renal calculi between 2000 and 2010.
  • Patients were stratified into two groups based on preoperative serum creatinine levels (≤1.5 mg% and >1.5 mg%).

Main Results:

  • PCNL was performed on 25 renal units with an overall stone clearance success rate of 88%.
  • Mean stone burden was 2.4 cm; two patients required repeat PCNL and one needed ESWL.
  • Postoperative serum creatinine improved in patients with higher preoperative levels; 13% required blood transfusion and 18% experienced fever, with no angioembolization needed.

Conclusions:

  • Percutaneous nephrolithotomy (PCNL) is a safe and effective treatment option for nephrolithiasis in ADPKD patients.
  • The procedure demonstrates good stone clearance rates despite the complex anatomy associated with ADPKD.
  • PCNL can be safely performed in ADPKD patients with chronic kidney disease, with manageable complication rates.
Abstract

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