Percutaneous Nephrolithotomy in Immunocompromised Patients: Outcomes from a Matched Case-Control Study

Area of Science:

• Urology
• Nephrology
• Immunology

Background:

• Percutaneous nephrolithotomy (PCNL) is a common procedure for kidney stone removal.
• Immunocompromised patients may have different outcomes due to their altered immune status.

Purpose of the Study:

• To compare PCNL outcomes between immunocompromised patients and a healthy control group.
• To identify specific risks associated with PCNL in immunocompromised individuals.

Main Methods:

• A matched case-control study was conducted from 2009-2014.
• Case group: Immunocompromised patients (HIV, Hepatitis C, autoimmune diseases on immunosuppressants).
• Control group: Healthy patients with kidney stones, matched by Guy's score.

Main Results:

• Higher overall complication rates (38.1% vs 14.3%) and increased risk of bleeding/transfusion in immunocompromised patients.
• No significant difference in major complications (Clavien score ≥3) between groups.
• Similar stone-free rates, nephrostomy tube time, and hospital stay.

Conclusions:

• Immunocompromised patients have an elevated risk of bleeding complications post-PCNL.
• PCNL can be performed with comparable rates of major complications and stone clearance in this population.