Does percutaneous nephrolithotomy cause elevated cardiac troponins?

Area of Science:

• Nephrology
• Cardiology
• Urology

Background:

• Percutaneous nephrolithotomy (PCNL) is a primary treatment for large and staghorn renal calculi.
• Myocardial infarction is a recognized complication of PCNL.
• The study investigates whether renal and skeletal muscle injury from PCNL elevates cardiac troponins (cTn).

Purpose of the Study:

• To determine if percutaneous nephrolithotomy-induced renal and skeletal muscle injury elevates cardiac troponins.
• To differentiate between non-cardiac causes of troponin elevation and actual cardiovascular events post-PCNL.

Main Methods:

• Prospective study on 55 otherwise healthy patients undergoing PCNL for renal stones.
• Baseline ECG, echocardiography, and cardiac troponin T (cTnT), troponin I (cTnI), and creatine kinase (CK) assessments confirmed no pre-existing cardiac pathology.
• cTnT, cTnI, and CK levels were measured pre- and post-surgery.

Main Results:

• Creatine kinase levels significantly increased post-surgery (469.5 ± 201.4 U/l, P < 0.001).
• No elevation in cardiac troponin T or cardiac troponin I was detected after percutaneous nephrolithotomy.
• Serum creatinine levels remained within the normal range (0.7-1.3 mg/dl).

Conclusions:

• Renal cell injury from percutaneous nephrolithotomy is not associated with elevated cardiac troponins.
• Post-operative troponin increases in PCNL patients suggest underlying cardiovascular pathology.
• This finding helps in accurately diagnosing cardiac events in patients recovering from kidney stone surgery.