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The Effect of Percutaneous Nephrolithotomy on the Estimated Glomerular Filtration Rate in Patients with Chronic Kidney Disease.

OBJECTIVE
We evaluated the influence of percutaneous nephrolithotomy (PCNL) on estimated glomerular filtration rate (eGFR) in patients with chronic kidney disease (CKD).


MATERIALS AND METHODS
Between September 2007 and April 2019 were retrospectively evaluated 280 patients with a preoperative eGFR levels less than 90 ml/min/1.73 m2 who underwent PCNL were retrospectively examined. The primary endpoint of this study was the effect of PCNL on eGFR levels in the first month and 12th month after surgery in patients with CKD according to CKD stages. The secondary endpoint of this study was the identification of potential risk factors for deteriorated eGFR.


RESULTS
The mean eGFR of the patients was 48.7±17 ml/min/1.73 m2 in the preoperative period, 54.7±21 ml/min/1.73 m2 in the postoperative the first month, and 59.1±23.2 ml/min/1.73 m2 in the postoperative 12th month. It was determined that the increases in the eGFR in the postoperative the first and 12th months were significant in all CKD stages (p<0.005). Compared to the preoperative values, the eGFR value was reduced in 61 (21.8%) patients in the first month and 49 (17.5%) patients in 12th months. When these patients were compared with those in the stable-eGFR and/or recovery group, multiaccess was an independent risk factor for renal function deterioration at the postoperative the first and 12th month on multivariate analysis (odds ratios were 6.94 and 9.46, respectively).


CONCLUSION
PCNL was found to have a positive effect on the short- and long-term eGFR in patients with CKD. However, multiaccess may have adversely affected the eGFR in both the short and long term.