World journal of urology · 2025
Long-term outcomes of percutaneous nephrolithotomy in 502 chronic kidney disease patients: insights from a tertiary center.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Srivastava Nalin Kumar, Panwar Vikas Kumar, Mittal Ankur, Mandal Arup Kumar, Agarwal Harshit
Аннотация
INTRODUCTION: Urinary stone disease is a significant risk factor for chronic kidney disease. Percutaneous nephrolithotomy is the standard treatment for complex renal stones, yet its long-term effects on renal function in such patients remain underexplored. This study evaluates the outcomes, complications, and factors influencing percutaneous nephrolithotomy success in chronic kidney disease patients.
MATERIALS AND METHODS: This single-center study included 502 chronic kidney disease patients undergoing percutaneous nephrolithotomy between March 2019 and April 2024. Outcomes assessed were changes in effective glomerular filtration rate, stone-free rates, complications (Clavien-Dindo classification), and mortality. Preoperative, intraoperative, and postoperative parameters were analyzed, and follow-up outcomes were recorded and analyzed.
RESULTS: The cohort's mean age was 47.25 ± 13.48 years, with 65.9% males. Complete stone clearance was achieved in 89.28%, with an operative time of 95.05 ± 29.47 min. Complications occurred in 28%, primarily urosepsis (12.79%), urinary tract infections (9.6%), and bleeding (4.6%). Effective glomerular filtration rate improved significantly postoperatively (63.97 ± 24.01 to 84.40 ± 26.87 mL/min/1.73 m²). At a median follow-up of 20.01 months, 50.8% of patients showed stage improvement, while 7% experienced deterioration. The stone-free rate was 90.2%, with a recurrence rate of 4.38%. Mortality was 3.6%, primarily in Stage 5 patients.
CONCLUSION: Percutaneous nephrolithotomy is effective in managing renal stones in chronic kidney disease patients, improving or stabilizing renal function in most cases. While complications are higher in this population, careful preoperative planning and surgical techniques optimize outcomes. Further research is needed to refine protocols and patient selection.
MATERIALS AND METHODS: This single-center study included 502 chronic kidney disease patients undergoing percutaneous nephrolithotomy between March 2019 and April 2024. Outcomes assessed were changes in effective glomerular filtration rate, stone-free rates, complications (Clavien-Dindo classification), and mortality. Preoperative, intraoperative, and postoperative parameters were analyzed, and follow-up outcomes were recorded and analyzed.
RESULTS: The cohort's mean age was 47.25 ± 13.48 years, with 65.9% males. Complete stone clearance was achieved in 89.28%, with an operative time of 95.05 ± 29.47 min. Complications occurred in 28%, primarily urosepsis (12.79%), urinary tract infections (9.6%), and bleeding (4.6%). Effective glomerular filtration rate improved significantly postoperatively (63.97 ± 24.01 to 84.40 ± 26.87 mL/min/1.73 m²). At a median follow-up of 20.01 months, 50.8% of patients showed stage improvement, while 7% experienced deterioration. The stone-free rate was 90.2%, with a recurrence rate of 4.38%. Mortality was 3.6%, primarily in Stage 5 patients.
CONCLUSION: Percutaneous nephrolithotomy is effective in managing renal stones in chronic kidney disease patients, improving or stabilizing renal function in most cases. While complications are higher in this population, careful preoperative planning and surgical techniques optimize outcomes. Further research is needed to refine protocols and patient selection.