Renal function markers in single-kidney patients after percutaneous nephrolithotomy: A pilot study

Area of Science:

• Nephrology
• Urology
• Surgical Innovation

Background:

• Single-kidney patients with staghorn calculus present unique challenges for renal stone treatment.
• Percutaneous nephrolithotomy (PCNL) is a common procedure for kidney stone removal.
• Assessing renal function post-PCNL is crucial, especially in patients with compromised renal mass.

Purpose of the Study:

• To investigate and compare renal functions in single-kidney patients 12 hours after PCNL.
• To evaluate key renal function markers, including cystatin C, creatinine, eGFR, and NGAL.
• To determine the safety and efficacy of PCNL in single-kidney patients with large stones.

Main Methods:

• A pilot quasi-experimental study involving 92 single-kidney patients with staghorn calculus.
• Serum levels of cystatin C and creatinine, estimated glomerular filtration rate (eGFR), and urinary NGAL were measured before and 12 hours post-PCNL.
• Statistical analysis was performed to compare pre- and post-operative renal function markers.

Main Results:

• Significant decrease in mean serum cystatin C (1.58 vs. 1.46 mg/L, P < 0.001) and creatinine (2.04 vs. 1.89 mg/dL, P < 0.05) 12 hours post-PCNL.
• Significant decrease in mean urinary NGAL levels (39.72 vs. 24.05 μg/ml, P < 0.05).
• Significant increase in mean eGFR (57.62 vs. 64.68 ml/min/1.73 m², P < 0.001) after the procedure.

Conclusions:

• PCNL demonstrates a significant improvement in renal function markers within 12 hours post-surgery in single-kidney patients.
• The observed improvements suggest PCNL is a safe and effective approach for managing large renal stones in this vulnerable patient group.
• Cystatin C, creatinine, eGFR, and NGAL are reliable indicators for assessing renal function changes after PCNL.