Baseline chronic kidney disease does not predict long-term renal functional decline after percutaneous...

Area of Science:

• Nephrology
• Urology
• Surgical Outcomes

Background:

• Chronic kidney disease (CKD) affects renal function and is associated with kidney stone formation.
• Percutaneous nephrolithotomy (PCNL) is a common procedure for kidney stone removal.
• Understanding the impact of PCNL on renal function in CKD patients is crucial for clinical decision-making.

Purpose of the Study:

• To compare renal functional outcomes after PCNL in patients with and without pre-existing chronic kidney disease (CKD).
• To identify predictors of changes in renal function following PCNL.

Main Methods:

• Retrospective review of 202 patients undergoing PCNL.
• Calculation of pre- and post-operative Glomerular Filtration Rate (GFR).
• Multivariate analysis to identify predictors of post-operative renal function.

Main Results:

• Patients without CKD showed a non-significant decrease in GFR; 8.6% experienced a significant decline, with 4.3% developing de novo CKD.
• Patients with CKD demonstrated a trend towards improved GFR post-operatively (p=0.067), with only 5.1% experiencing a significant decline.
• Pre-operative CKD, comorbidities, age, gender, and race were not significant predictors of post-operative renal function.

Conclusions:

• PCNL appears to be GFR neutral in patients with baseline CKD.
• Pre-existing CKD is not a predictor of renal functional decline after PCNL.
• Further research is warranted to identify predictors of renal function change after PCNL, considering the high recurrence of stone disease in CKD patients.