Role of Endourological Procedures (PCNL and URS) on Renal Function: a Systematic Review

Reeves, Thomas; Pietropaolo, Amelia; Gadzhiev, Nariman; Seitz, Christian; Somani, Bhaskar K.

doi:10.1007/s11934-020-00973-4

Cited by 27 publications

(13 citation statements)

References 53 publications

(91 reference statements)

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“…The choice of treatment depends on stone factors, patient factors including comorbidities, surgical expertise, and also underlying renal function. A systematic review by Reeves et al suggests that the overall renal function is not always detrimentally affected by endourological interventions [2]. Morbidities after PNL such as fever, bleeding, pleural or visceral injury and significant nephron loss have been well described [11].…”

Section: Discussionmentioning

confidence: 99%

“…Effect on renal function is influenced by preoperative renal status and presence of comorbidities such as diabetes mellitus and hypertension [15]. Violation of the renal parenchyma, high irrigation pressure, tract multiplicity, preoperative urine infection and postoperative bleeding are reported as attributes causing post-PNL AKI [2,16]. However, subsequent improvement in renal function is seen in almost all renal units that are obstructed and infected [15,17].…”

Section: Discussionmentioning

confidence: 99%

“…A perceived drawback of PNL is its deleterious effect on renal function. Short-and long-term effects of PNL have been studied [2]; however, data on incidence of Acute Kidney Injury (AKI) following PNL is sparse. Kidney Disease: Improving Global Outcomes (KDIGO) [3,4] has defined and issued practice guidelines for AKI to optimize its management [3][4][5][6][7].…”

Section: Introductionmentioning

confidence: 99%

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Acute Kidney Injury Post-Percutaneous Nephrolithotomy (PNL): Prospective Outcomes from a University Teaching Hospital

Pillai

Kriplani

Chawla

et al. 2021

JCM

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Acute Kidney Injury (AKI) after percutaneous nephrolithotomy (PNL) is a significant complication, but evidence on its incidence is bereft in the literature. The objective of this prospective observational study was to analyze the incidence of post-PNL AKI and the potential risk factors and outcomes. Demographic data collected included age, gender, body mass index (BMI), comorbidities (hypertension, diabetes mellitus), and drug history—particularly angiotensin converting enzyme inhibitors (ACE inhibitors), angiotensin II receptor blockers and beta blockers. Laboratory data included serial serum creatinine measured pre- and postoperation (12, 24, and 48 h), hemoglobin (Hb), total leucocyte count (TLC), Prothrombin time (PT), serum uric acid and urine culture. Stone factors were assessed by noncontrast computerized tomography of kidneys, ureter and bladder (NCCT KUB) and included stone burden, location and Hounsfield values. Intraoperative factors assessed were puncture site, tract size, tract number, operative time, the need for blood transfusion and stone clearance. Postoperative complications were documented using the modified Clavien–Dindo grading system and patients with postoperative AKI were followed up with serial creatinine measurements up to 1 year. Among the 509 patients analyzed, 47 (9.23%) developed postoperative AKI. Older patients, with associated hypertension and diabetes mellitus, those receiving ACE inhibitors and with lower preoperative hemoglobin and higher serum uric acid, had higher incidence of AKI. Higher stone volume and density, staghorn stones, multiple punctures and longer operative time were significantly associated with postoperative AKI. Patients with AKI had an increased length of hospital stay and 17% patients progressed to chronic kidney disease (CKD). Cut-off values for patient age (39.5 years), serum uric acid (4.05 mg/dL) and stone volume (673.06 mm3) were assessed by receiver operating characteristic (ROC) curve analysis. Highlighting the strong predictors of post-PNL AKI allows early identification, proper counseling and postoperative planning and management in an attempt to avoid further insult to the kidney.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Acute Kidney Injury Post-Percutaneous Nephrolithotomy (PNL): Prospective Outcomes from a University Teaching Hospital

Pillai

Kriplani

Chawla

et al. 2021

JCM

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“…KSD is an important risk factor for renal dysfunction which could have important implications for further management options post-operatively [33]. This is important for IBD and cancer patients where a wide range of medical therapies including chemotherapy are available that patients with chronic kidney disease (CKD) may not be able to access [17•].…”

Section: Implications For Clinical Practicementioning

confidence: 99%

“…tea, spinach, bananas) and increased fluid intake. Oral calcium supplements may be considered as an option because they bind with enteric oxalate, reducing the amount of free oxalate being absorbed and excreted renally [33]. There are medications to help reduce urinary calcium excretion and so increase enteric calcium concentrations and reduce enteric free oxalate concentrations.…”

Section: Implications For Clinical Practicementioning

confidence: 99%

Association of Kidney Stone Disease (KSD) with Primary Gastrointestinal Surgery: a Systematic Review over Last 2 Decades

Premakumar¹,

Gadiyar

Hameed

et al. 2021

Curr Urol Rep

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Purpose of review We aim to provide an up-to-date literature review to further characterise the association of kidney stone disease (KSD) with gastrointestinal (GI) surgery. As KSD is associated with significant morbidity, it is important to quantify and qualify this association to provide better care and management for the patient subgroup. Objective To perform a systematic review of the existing literature to evaluate the association of KSD following GI surgery. Methods A literature search was performed of the following databases: MEDLINE, EMBASE, Scopus, Google Scholar, Key Urology, Uptodate and Cochrane Trials from January 2000 to June 2020. Recent Findings A total of 106 articles were identified, and after screening for titles, abstracts and full articles, 12 full papers were included. This involved a total of 9299 patients who underwent primary GI surgery. Over a mean follow-up period of 5.4 years (range: 1–14.4 years), 819 (8.8%) developed KSD, varying from 1.2 to 83% across studies. The mean time to stone formation was approximately 3 years (range: 0.5–9 years). In the 4 studies that reported on the management of KSD (n = 427), 38.6% went on to have urological intervention. Summary There is a high incidence of KSD following primary GI surgery, and after a mean follow-up of 3 years, around 9% of patients developed KSD. While the GI surgery was done for obesity, inflammatory bowel disease or cancer, the risk of KSD should be kept in mind during follow-up, and prompt urology involvement with metabolic assessment, medical and or surgical management offered as applicable.

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Complications of Percutaneous Nephrolithotomy

Kominsky,

Lieb,

Knoll

et al. 2023

Percutaneous Renal Surgery

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Role of Endourological Procedures (PCNL and URS) on Renal Function: a Systematic Review

Cited by 27 publications

References 53 publications

Acute Kidney Injury Post-Percutaneous Nephrolithotomy (PNL): Prospective Outcomes from a University Teaching Hospital

Acute Kidney Injury Post-Percutaneous Nephrolithotomy (PNL): Prospective Outcomes from a University Teaching Hospital

Association of Kidney Stone Disease (KSD) with Primary Gastrointestinal Surgery: a Systematic Review over Last 2 Decades

Complications of Percutaneous Nephrolithotomy

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