Investig Clin Urol.  2020 Jan;61(1):59-66. 10.4111/icu.2020.61.1.59.

Postoperative renal functional changes assessed by (99m)Tc-DTPA scintigraphy and predictive factors after miniaturized percutaneous nephrolithotomy and retrograde intrarenal surgery: An observational 1-year follow-up study

• Jung JH
• Yoo S
• Park J
• Cho MC
• Son H
• Jeong H
• Ryang SH
• Cho SY

• KMID: 2466793
• DOI: http://doi.org/10.4111/icu.2020.61.1.59

Abstract

PURPOSE
We evaluated the comparative effect of miniaturized percutaneous nephrolithotomy (mini-PCNL) and retrograde intrarenal surgery (RIRS) on perioperative kidney function by use of diethylenetriamine penta-acetic acid ((99m)Tc-DTPA) scintigraphy and identified significant predictors associated with deterioration or amelioration of renal function after surgery.
MATERIALS AND METHODS
All 70 patients who underwent mini-PCNL or RIRS between 2012 and 2016 were monitored by (99m)Tc-DTPA scintigraphy preoperatively. Patients with abnormal renal function were monitored from 3 to 12 months postoperatively. Logistic regression analyses were conducted to estimate the predictors of aggravated renal dysfunction and improvement.
RESULTS
The difference in preoperative renal function between the contralateral and the operative side was >10% in 57 patients (81.4%). Among those in the group with abnormal renal function, 40 (70.2%), 10 (17.5%), and 7 (12.3%) patients showed stability, deterioration, and improvement in renal function at postoperative year 1, respectively. Functional changes did not differ according to the type of surgery. A high level of serum creatinine preoperatively (p=0.060) and a history of previous stone procedures (p=0.051) showed borderline significance for prediction of deterioration in renal function.
CONCLUSIONS
RIRS and mini-PCNL had similar effects and favorable outcomes on renal function during a 1-year follow-up period. High baseline serum creatinine levels and a history of procedures warrant careful attention.

Keyword

Kidney calculi; Kidney function tests; Minimally invasive surgical procedures; Urinary calculi

MeSH Terms

Creatinine
Follow-Up Studies*
Humans
Kidney
Kidney Calculi
Kidney Function Tests
Logistic Models
Minimally Invasive Surgical Procedures
Nephrostomy, Percutaneous*
Radionuclide Imaging*
Urinary Calculi
Creatinine

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