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Piao S, Park J, Son H, et al. Evaluation of renal function in patients with a main renal stone larger than 1 cm and perioperative renal functional change in minimally invasive renal stone surgery: a prospective, observational study. World J Urol. 2015;34(5):725-32doi: 10.1007/s00345-015-1653-x.
Piao, S., Park, J., Son, H., Jeong, H., & Cho, S. Y. (2016). Evaluation of renal function in patients with a main renal stone larger than 1 cm and perioperative renal functional change in minimally invasive renal stone surgery: a prospective, observational study. World journal of urology, 34(5), 725-32. https://doi.org/10.1007/s00345-015-1653-x
Piao, Songzhe, et al. "Evaluation of renal function in patients with a main renal stone larger than 1 cm and perioperative renal functional change in minimally invasive renal stone surgery: a prospective, observational study." World journal of urology vol. 34,5 (2016): 725-32. doi: https://doi.org/10.1007/s00345-015-1653-x
Piao S, Park J, Son H, Jeong H, Cho SY. Evaluation of renal function in patients with a main renal stone larger than 1 cm and perioperative renal functional change in minimally invasive renal stone surgery: a prospective, observational study. World J Urol. 2016 May;34(5):725-32. doi: 10.1007/s00345-015-1653-x. Epub 2015 Jul 31. PMID: 26226940.
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World J Urol. 2016 May;34(5):725-32. doi: 10.1007/s00345-015-1653-x. Epub 2015 Jul 31.

Evaluation of renal function in patients with a main renal stone larger than 1 cm and perioperative renal functional change in minimally invasive renal stone surgery: a prospective, observational study.

World journal of urology

Songzhe Piao, Juhyun Park, Hwancheol Son, Hyeon Jeong, Sung Yong Cho

Affiliations

  1. Department of Urology, Seoul National University Hospital, Seoul, Republic of Korea.
  2. Department of Urology, Yanbian University Hospital, Yanji, Jilin, China.
  3. Department of Urology, SMG-SNU Boramae Medical Center, Sindaebang 2-dong, 395, Dongjak-gu, Seoul, 156-707, Republic of Korea.
  4. Department of Urology, SMG-SNU Boramae Medical Center, Sindaebang 2-dong, 395, Dongjak-gu, Seoul, 156-707, Republic of Korea. [email protected].

PMID: 26226940 DOI: 10.1007/s00345-015-1653-x

Abstract

PURPOSE: To compare the perioperative relative renal function and determine predictors of deterioration and recovery of separate renal function in patients with renal stones >10 mm and who underwent mini-percutaneous nephrolithotomy or retrograde intra-renal surgery.

PATIENTS AND METHODS: A main stone >10 mm or stones growing, high-risk stone formers and extracorporeal shock-wave lithotripsy-resistant stones were prospectively included in 148 patients. Patients with bilateral renal stones and anatomical deformities were excluded. Renal function was evaluated by estimated glomerular filtration rate, 99m-technetium dimercaptosuccinic acid and 99m-technetium diethylenetriamine pentaacetate prior to intervention and at postoperative 3 months. Logistic regression analyses were performed to find predictors of functional deterioration and recovery.

RESULTS: The overall stone-free rate was 85.1 %. A third of patients (53/148, 35.8 %) with renal stones >10 mm showed deterioration of separate renal function. Mean renal function of operative sites showed 58.2 % (36.8 %/63.2 %) of that of contralateral sites in these patients. Abnormal separate renal function showed postoperative recovery in 31 patients (58.5 %). Three cases (5.7 %) showed deterioration of separate renal function despite no presence of remnant stones. Improvement rates of the abnormal separate renal function did not differ according to the type of surgery. The presence of hydronephrosis and three or more stones were significant predictors for renal function deterioration. Female gender and three or more stones were significantly correlated with postoperative recovery.

CONCLUSIONS: Mini-percutaneous nephrolithotomy or retrograde intra-renal surgery was effective and safe for renal function preservation. Patients with multiple large stones should be considered for candidates of active surgical removal.

Keywords: Gadolinium DTPA; Kidney calculi; Kidney function tests; Laser; Lithotripsy; Nephrostomy; Percutaneous; Technetium 99m dimercaptosuccinic acid; Urolithiasis

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