ABSTRACT
Introducción: El mayor motivo de preocupación durante el perioperatorio y postoperatorio de la nefrolitotomía percutánea (NLP) es el sangrado. Se determinaron las condiciones relacionadas con la enfermedad (tamaño del cálculo, UH del cálculo, número de trayectos y diámetro) que afectan el desarrollo de esta condición, con el objetivo de conocer los factores de riesgo independientes que pueden afectar el volumen del sangrado en la NLP.Material y método: Se incluyeron en el estudio un total de 308 pacientes adultos (211 hombres y 97 mujeres) sometidos al procedimiento de NLP. La anatomía renal y el tamaño de los cálculos se evaluaron mediante tomografía computarizada de corte fino sin contraste. Esta prueba de imagen se utilizó para evaluar los valores de unidades Hounsfield (UH) de los cálculos renales, la presencia de placas de ateroma y la obesidad. Se registró la diferencia entre el valor preoperatorio de hemoglobina (Hgb) y el valor de Hgb del primer día del postoperatorio. Se evaluó esta variación en función del sexo, la edad, la enfermedad vascular aterosclerótica, el pH y la densidad de la orina, el recuento de leucocitos, de linfocitos, de neutrófilos (NEU) y de plaquetas, el volumen plaquetario medio (VPM), el índice neutrófilo-linfocito (INL), el índice plaqueta-linfocito, el volumen de los cálculos, las UH y la obesidad.Resultados: La variación media de Hgb se identificó como 2,1 (desviación estándar: 1,6). Hubo correlaciones positivas, significativas y débiles entre la variación de Hgb con los valores de NEU (p=0,019), VPM (p=0,000), INL (p=0,005), volumen del cálculo (p=0,041) y UH (p=0,024). Hubo una correlación negativa significativa y débil entre la variación de la Hgb y el recuento PLT (p=0,022). No se identificaron efectos a niveles significativos del sexo (p=0,078), la presencia de placas de ateroma (p=0,949), la obesidad (p=0,869), la edad (AU)
Introduction: The perioperative and postoperative concern in percutaneous nephrolithotomy (PNL) is bleeding. Disease-related conditions (such as stone size, stone HU, tract number, and diameter) affecting this situation were determined. To determine independent risk factors that may affect the amount of hemorrhage in PNL.Material and method: A total of 308 adult patients (211 men, 97 women) undergoing the PNL procedure were included in the study. Renal anatomy and stone size were evaluated using non-contrast thin-section computed tomography (NCCT). NCCT was used to assess Hounsfield unit (HU) values of kidney stones, presence of atheroma plaque and obesity. The difference between preoperative hemoglobin (Hgb) values and postoperative 1st day Hgb values was recorded. This variation was evaluated for the effect of gender, age, atherosclerotic vein disease, urine pH and density, leukocyte count, lymphocyte count, neutrophil count (NEU), platelet count, mean platelet volume (MPV), neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), stone volume, HU, and obesity.ResultsThe mean Hgb variation was identified as 2.1 (standard deviation: 1.6). There were positive, significant, and weak correlations between the Hgb variation with NEU (P=.019), MPV (P=.000), NLR (P=.005), stone volume (P=.041) and HU (P=.024) values. There was a negative significant and weak correlation between Hgb variation and PLT (P=.022). No effects at significant levels were identified for gender (P=.078), presence of atheroma plaque (P=.949), obesity (P=.869), age (P=.686), urine pH (P=.746), urine density (P=.421), and PLR (P=.855) on Hgb variations.Conclusion: In addition to HU and stone volume, NEU count, MPV, NLR and PLT count may be used as independent risk factors to predict blood loss during PNL (AU)
Subject(s)
Humans , Male , Female , Nephrolithotomy, Percutaneous/adverse effects , Obesity , Plaque, Atherosclerotic/etiology , Retrospective Studies , Risk Factors , Nephrolithotomy, Percutaneous/methods , HemorrhageABSTRACT
INTRODUCTION: The perioperative and postoperative concern in percutaneous nephrolithotomy (PNL) is bleeding. Disease-related conditions (such as stone size, stone HU, tract number, and diameter) affecting this situation were determined. To determine independent risk factors that may affect the amount of hemorrhage in PNL. MATERIAL AND METHOD: A total of 308 adult patients (211 men, 97 women) undergoing the PNL procedure were included in the study. Renal anatomy and stone size were evaluated using non-contrast thin-section computed tomography (NCCT). NCCT was used to assess Hounsfield unit (HU) values of kidney stones, presence of atheroma plaque and obesity. The difference between preoperative hemoglobin (Hgb) values and postoperative 1st day Hgb values was recorded. This variation was evaluated for the effect of gender, age, atherosclerotic vein disease, urine pH and density, leukocyte count, lymphocyte count, neutrophil count (NEU), platelet count, mean platelet volume (MPV), neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), stone volume, HU, and obesity. RESULTS: The mean Hgb variation was identified as 2.1 (standard deviation: 1.6). There were positive, significant, and weak correlations between the Hgb variation with NEU (P=0.019), MPV (P=0.000), NLR (P=0.005), stone volume (P=0.041) and HU (P=0.024) values. There was a negative significant and weak correlation between Hgb variation and PLT (P=0.022). No effects at significant levels were identified for gender (P=0.078), presence of atheroma plaque (P=0.949), obesity (P=0.869), age (P=0.686), urine pH (P=0.746), urine density (P=0.421), and PLR (P=0.855) on Hgb variations. CONCLUSION: In addition to HU and stone volume, NEU count, MPV, NLR and PLT count may be used as independent risk factors to predict blood loss during PNL.
Subject(s)
Nephrolithotomy, Percutaneous , Plaque, Atherosclerotic , Adult , Male , Humans , Female , Nephrolithotomy, Percutaneous/adverse effects , Nephrolithotomy, Percutaneous/methods , Retrospective Studies , Plaque, Atherosclerotic/etiology , Risk Factors , Hemorrhage/etiology , ObesityABSTRACT
INTRODUCTION: This study sought to evaluate the correlation of ischemia-modified albumin (IMA) with time-dependent renal ischemic injury. METHODS: We established 5 groups of 8 Wistar albino rats as follows: sham, 10 minutes of renal ischemia, 20 minutes of renal ischemia, 30 minutes of renal ischemia, and 40 minutes of renal ischemia. Renal ischemia was established by occlusion of the right renal pedicle. Blood samples were obtained after exploration of the renal pedicle in the sham group and after thoracotomy and directly from the cardiac chambers at the end of the ischemic period in the other groups. The ischemic kidneys were removed for histopathological evaluation, and the rats were killed. RESULTS: There were significant differences among the IMA levels of the 5 groups (P = .0013). Pathological examination showed that renal ischemic injury corresponded to the duration of ischemia. In the group analysis, the pathological evaluation scores were significantly different among the groups (P < .001). CONCLUSIONS: This study shows that IMA levels can be used as a nonselective biomarker for renal ischemic injury. However, further studies are needed to support our findings.
