Nephrolithiasis Manage by Percutaneous Nephrolithotomy in Patients with Renal Insufficiency
Journal Title: International Journal of Medical Research Professionals - Year 2018, Vol 4, Issue 1
Abstract
Introduction: The prevalence of nephrolithiasis are depends on multiple factors. Commonly renal stone disease depends on climate, environment, genetic factor, geographical distribution, ethnic factor, diet. Renal stones may lead to varying degrees of renal insufficiency by due to urinary stasis and chronic infections. According to the European association of urology guideline 2015, percutaneous nephrolithotomy (PCNL) is the standard surgical treatment for large renal stones. We aimed to determine the impact of PCNL management on renal functions in renal stone patients with renal insufficiency. Objective: To study and compare the parameters associated with PCNL management for nephrolithisis in patients with renal insufficiency and evaluate the post-operative outcomes based on differences in preoperative renal function test values in patients who underwent percutaneous nephrolithotomy. Methods: From July 2014 to December 2016, in the present study, in a series of continuous 640 patients who were operated by PCNL, 65 patients with altered serum creatinine more than 1.5 were studied, observed and followed. All data were collected from medical records, which contained the clinical, laboratory evaluation and diagnostic imaging. Results: Average age among the study group was 47.75 years being youngest 28 yrs and the eldest 70 yrs. M: F ratio was 44 (67.69%):21 (32.30%). In present study pre operatively 32, 24 patients out of total 65 patients were inserted PCN tube, D J stent and in remaining 9 patients were without PCN or D J stent insertion. Pre-operative hemodialysis was done in 39 out of 65 patients. Mean operative time 127 min (30-180 min). In the study 7 (10.76%) patients out of 65 total patients required blood transfusion. In study group mean haematuria time was 15.98 hrs (6- 33 hrs). Average drop in hemoglobin percentage was 1.6. Mean hospital stay was 3.6 days. Conclusions: The patients of renal stones with compromised renal insufficiency benefit from the elimination of calculi from the urinary tract, which may lead to improved renal function and avoidance or postponement of dialysis. On the other hand, there is concern for the detrimental effect of surgical and endourological procedures on kidney function and the possibility of increased complications in patients with kidney failure.
Authors and Affiliations
Shailesh P. Bajaniya
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- EP ID EP531337
- DOI 10.21276/ijmrp.2018.4.1.137
- Views 79
- Downloads 0
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