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Renal-stone dissolution via percutaneous nephrostomy

S P Dretler, R C Pfister, J H Newhouse

    The New England Journal of Medicine
    |February 15, 1979
    PubMed
    Summary
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    Percutaneous nephrostomy with hemiacidrin irrigation effectively dissolved most triple phosphate kidney stones in patients with recurrent urinary infections. This minimally invasive technique offers a promising alternative to surgery for certain kidney stone types.

    Area of Science:

    • Urology
    • Nephrology
    • Infectious Diseases

    Background:

    • Recurrent kidney stones often associate with urinary tract infections.
    • Triple phosphate stones (struvite) are a common type, posing treatment challenges.

    Purpose of the Study:

    • To evaluate the efficacy of percutaneous nephrostomy and hemiacidrin irrigation for treating infected renal stones.
    • To assess the safety and outcomes of this minimally invasive approach.

    Main Methods:

    • Eight kidneys in six patients with infected renal stones underwent percutaneous nephrostomy.
    • Irrigation with hemiacidrin, an organic acid and magnesium solution, was employed to dissolve the stones.
    • Stone composition was presumed to be triple phosphate (magnesium, ammonium, and calcium phosphate).

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    Main Results:

    • Complete dissolution of stones was achieved in six kidneys.
    • Partial dissolution occurred in two kidneys, with stones subsequently removed by other methods.
    • No serious complications were reported during the treatment.

    Conclusions:

    • Percutaneous nephrostomy with hemiacidrin irrigation is a potentially effective therapy for specific types of infected kidney stones.
    • The technique offers an alternative to surgery and general anesthesia, though precautions against infection spread are necessary.