The impact of chronic kidney disease stages and CROES AND GSS scores on stone free rate in kidney stones.

INTRODUCTION

This study evaluates the impact of chronic kidney disease (CKD) stages on stone-free rates (SFR) and renal function outcomes after percutaneous nephrolithotomy (PCNL). Additionally, it examines the predictive role of the CROES and Guy's Stone Score (GSS) systems.

METHODS

Data from 2994 patients who underwent PCNL between 2007 and 2024 were retrospectively analyzed. Patients were classified into four CKD groups based on preoperative estimated glomerular filtration rate (eGFR). SFR, complication rates, and postoperative renal function changes were assessed.

RESULTS

SFR was significantly lower in advanced CKD stages (p < 0.001), with the lowest in Group A (GFR < 30, 64.1%) and highest in Group D (GFR > 90, 79.1%). Postoperative eGFR increased in CKD stage 4-5 but declined in normal kidney function groups. Complication rates were higher in advanced CKD stages (p = 0.031). CROES and GSS scores correlated with stone complexity and surgical outcomes (p < 0.001).

CONCLUSION

Advanced CKD is associated with lower SFR, greater surgical complexity, and higher complication rates. PCNL remains an effective treatment, particularly in CKD patients, with potential postoperative renal function improvement. Utilizing predictive scoring systems can optimize patient selection and surgical planning. Further prospective studies are needed to validate these findings.