Does percutaneous nephrolithotomy and its outcomes have an impact on renal function? Quantitative analysis using...

Area of Science:

• Nephrology
• Urology
• Radiology

Background:

• Percutaneous nephrolithotomy (PCNL) is a common procedure for kidney stone removal.
• Assessing the functional impact of PCNL on the operated kidney is crucial for patient outcomes.

Purpose of the Study:

• To evaluate the functional effects and outcomes of PCNL on kidney function.
• To determine if stone-free status or complications influence kidney function post-PCNL.

Main Methods:

• Prospective study of 30 PCNL cases.
• Kidney function assessed pre- and post-surgery (3 months) using serum creatinine, GFR, and (99m)Tc-DMSA SPECT-CT for differential renal function (DRF).
• DRF analyzed globally (DRFPLANAR, DRFSPECT) and at the access site (DRFACCESS).

Main Results:

• PCNL achieved a 73% stone-free rate with a 33% complication rate.
• Global kidney function (serum creatinine, GFR) remained unchanged; however, DRFPLANAR and DRFSPECT decreased slightly (1.2% and 1.0%, respectively).
• The percutaneous access site showed the most significant DRF decrease (DRFACCESS, 1.8%).
• Complications led to significant impairment in serum creatinine, GFR, and all DRF measures.
• Stone-free status showed no impact on kidney function.

Conclusions:

• PCNL has a minimal impact on overall kidney function, localized primarily to the percutaneous access region.
• Perioperative complications significantly increase functional damage after PCNL.
• Achieving stone-free status post-PCNL does not negatively affect kidney function.