Impact of retrograde flexible ureteroscopy and intracorporeal lithotripsy on kidney functional outcomes
Hoarau, Nicolas; Martin, Francois; Lebdai, Souhil; Chautard, Denis; Culty, Thibaut; Azzouzi, Abdel Rahmene; Bigot, Pierre.
Int. braz. j. urol
; 41(5): 920-926, Sept.-Oct. 2015. tab
Artículo
en Inglés
| LILACS | ID: lil-767057
ABSTRACT
Objective:
The aim of the study was to evaluate renal function and to identify factors associated with renal function deterioration after retrograde intrarenal surgery (RIRS) for kidney stones. Materials andMethods:
We retrospectively analyzed patients with renal stones treated by RIRS between January 2010 and June 2013 at a single institute. We used the National Kidney Foundation classification of chronic kidney disease (CKD) to classify Glomerular Filtration Rate (GFR) in 5 groups. The baseline creatinine level was systematically pre-operatively and post-operatively evaluated. All patients had a creatinine blood measurement in June 2013. A change toward a less or a more favorable GFR group following RIRS was considered significant.Results:
We included 163 patients. There were 86 males (52.8%) and 77 females (47.3%) with a mean age of 52.8±17 years. After a mean follow-up of 15.5±11.5 months, median GFR was not significantly changed from 84.3±26.2 to 84.9±24.5 mL/min (p=0.675). Significant renal function deterioration occurred in 8 cases (4.9%) and significant renal function amelioration occurred in 23 cases (14.1%). In univariate analysis, multiple procedures (p=0.023; HR 5.4) and preoperative CKD (p=0.011; HR 6.8) were associated with decreased renal function. In multivariate analysis these factors did not remain as predictive factors.Conclusion:
Stone management with RIRS seems to have favorable outcomes on kidney function; however, special attention should be given to patients with multiple procedures and preoperative chronic kidney disease.Asunto(s)
Adulto Anciano Femenino Humanos Masculino Persona de Mediana Edad Cálculos Renales/terapia Riñón/fisiopatología Litotripsia por Láser/métodos Ureteroscopía/métodos Tasa de Filtración Glomerular Cálculos Renales/fisiopatología Litotripsia por Láser/efectos adversos Análisis Multivariante Periodo Perioperatorio Complicaciones Posoperatorias/etiología Complicaciones Posoperatorias/fisiopatología Estudios Retrospectivos Insuficiencia Renal Crónica/etiología Insuficiencia Renal Crónica/fisiopatología Índice de Severidad de la Enfermedad Resultado del Tratamiento Ureteroscopía/efectos adversos
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