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Acute kidney injury as a predictor of infectious complications after mini-PCNL

Angelo Cormio1,2, Daniele Castellani1,3, Domenico De Palma2

  • 1Urology Unit Azienda Ospedaliero-Universitaria delle Marche Ancona Italy.

BJUI Compass
|September 9, 2025
PubMed
Abstract

Insights

Acute kidney injury (AKI) occurred in 9.1% of patients after mini-percutaneous nephrolithotomy (mini-PCNL). AKI significantly increased postoperative complications and infectious risks, underscoring the need for vigilant monitoring and management.

Area of Science:

  • Nephrology
  • Urology
  • Surgical Complications

Background:

  • Acute kidney injury (AKI) is a potential complication following urological procedures.
  • Mini-percutaneous nephrolithotomy (mini-PCNL) is a minimally invasive technique for kidney stone removal.
  • Understanding AKI incidence and consequences after mini-PCNL is crucial for patient outcomes.

Purpose of the Study:

  • To determine the incidence and risk factors of AKI after mini-PCNL.
  • To investigate the clinical consequences of AKI, particularly its association with infectious complications.
  • To identify predictors for AKI development and postoperative infectious complications.

Main Methods:

  • Retrospective analysis of 496 adult patients undergoing mini-PCNL.
  • AKI defined by KDIGO criteria based on serum creatinine changes within 72 hours postoperatively.
  • Multivariable logistic regression used to identify predictors of AKI and infectious complications.

Main Results:

  • AKI incidence was 9.1% (45 patients).
  • Patients with AKI experienced higher rates of overall postoperative complications (24.4% vs 7.1%) and longer hospital stays.
  • AKI was an independent predictor of infectious complications (OR 3.47), with increased procalcitonin levels and one sepsis-related death.

Conclusions:

  • AKI following mini-PCNL is associated with significantly increased postoperative complications and infectious risks.
  • Previous PCNL and higher baseline serum creatinine are independent predictors of AKI.
  • Enhanced perioperative monitoring and management of infectious complications are recommended for patients with AKI post-mini-PCNL.
Keywords:
acute kidney injuryinfectious complicationskidney calculipercutaneous nephrolithotomy

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