Impact of percutaneous nephrolithotomy operation on non-operated kidney: a single center based study

Background: Effects of percutaneous nephrolithotomy (PCNL) operation on ipsilateral renal function are widely known but functional changes in opposite kidney are limited. Authors have conducted this study to evaluate the impact of PCNL operation on the contralateral side during early post-operative period.Methods: From 1st November 2016 to 30th September 2018, those patients presented with unilateral renal stone disease were enrolled. After exclusion they were subjected to PCNL operation under general anaesthesia. Along with preoperative period, 99 m Tc DTPA renal scan is repeated at 3rd and 14th post-operative period.Results: Out of 121 patients enrolled we included 96 patients after exclusion. They are divided into 3 age groups, 19-32, 33-47 and 48-60 years. The mean GFR at pre-operative, post-operative day-3 and 14 of normal kidney in these 3 age groups are 47.32, 47.63 and 42.32 ml/min, 44.29, 45.78 and 40.63 ml/min and 47.10, 48.47 and 41.01 ml/min respectively. At post op day-3 there are reduction of mean GFR in all age groups but statistically not significant (p >0.05). At post-operative day-14 GFR improved towards the pre-op value but the change is also not significant (p >0.05).Conclusions: There are reduction of GFR of contralateral normal kidney following PCNL operation in early post-operative period. So, along with operated kidney normal kidney also showed decrease GFR. It is better to avoid further trauma in post PCNL patient like avoidance of using nephrotoxic medication, contrast agents, ESWL, etc. This study can guide us to avoid further trauma of any kidney.

Changes of Glomerular Filtration Rate of Donated and Remnant Kidneys in a Week after Living Donor Kidney Transplantation / 대한이식학회지

PURPOSE: In living donor kidney transplantation, the initial function of donor's kidneys will be split into the function of the donor's remnant kidney and the recipient's implanted kidney. The question whether the function of these remnant and implanted kidneys will change after donation and transplantation was addressed. METHODS: The functional ratio of each kidney using (99m)Tc-Diethylenetriamine pentaacetic acid ((99m)Tc-DTPA) as well as serum creatinine (Scr, mg/dL) and 24-hour urine creatinine clearance (Ccr, mL/min/ 1.73 m(2)) from 100 donors were measured before donation. The kidney function was also calculated using Cockcroft-Gault formula (Ccr-CG, mL/min/ 1.73 m(2)). In donors and recipients, the Scr, Ccr, Ccr-CG were measured within a week after transplantation. RESULTS: The average functional ratio of the implanted kidney versus the remnant kidney before donation was 50.7 : 49.3. In implanted kidneys, the predonation Ccr and Ccr-CG were 56.7+/-9.4 mL/min/1.73 m(2) and 42.0+/-9.9 mL/min/1.73 m(2) which increased to 78.5+/-18.2 mL/min/1.73 m(2) and 53.2+/-16.4 mL/min/ 1.73 m(2) after transplantation. In remnant kidneys, the predonation Ccr and Ccr-CG were 54.5+/-10.9 mL/min/1.73 m(2) and 40.8+/-9.4/min/1.73 m(2) then increased to 68.0+/-14.2 mL/min/ 1.73 m(2) and 53.6+/-11.6 mL/min/1.73 m(2) after donation. CONCLUSION: Kidney transplantation from a living donor should be encouraged based on the total functional benefit of both donors and recipients after kidney donation and implantation.

The Correlation between Relative Renal Uptake of (99m)Tc-DMSA Renal Scan and Glomerular Filtration Rate in Patients with Reduced Renal Function / 대한신장학회잡지

BACKGROUND: Glomerular filtration rate(GFR) is an important parameter for the evaluation and monitoring of renal function. The aim of this study was to investigate the correlation between the relative 1 hour uptake of (99m)Tc-DMSA renal scan(DMSA- %uptake, TRUR) and GFR which was estimated by (99m)Tc-DTPA, serum creatinine and 24 hour-urinary creatinine excretion. METHODS: Between January 1998 and March 2001, 65 patients had undergone (99m)Tc-DMSA renal scan, (99m)Tc-DTPA renal scan, serum creatinine and 24 hour-urinary creatinine excretion. Of them, 42 patients had moderately or severely reduced renal function(DTPA-GFR 0.05). In group B, TRUR (mean+/-S.D. 16.3+/-7.4%) was significantly correlated with DTPA-GFR(r=0.731, p < 0.01). In both group, serum creatinine, Ccr and C and G Ccr were significantly correlated with TRUR. CONCLUSION: Although the relative 1 hour uptake of the (99m)Tc-DMSA renal scan, as a method of renal cortical image could not estimate the true GFR, it showed a good correlation with GFR in patients with moderately reduced renal function. (99m)Tc-DMSA renal scan seems to be helpful to evaluate the renal function in patients with moderately reduced renal function.