Impact of retrograde flexible ureteroscopy and intracorporeal lithotripsy on kidney functional outcomes

Int Braz J Urol. 2015 Sep-Oct;41(5):920-6. doi: 10.1590/S1677-5538.IBJU.2014.0402.

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 and methods: 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.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Aged
  • Female
  • Glomerular Filtration Rate
  • Humans
  • Kidney / physiopathology*
  • Kidney Calculi / physiopathology
  • Kidney Calculi / therapy*
  • Lithotripsy, Laser / adverse effects
  • Lithotripsy, Laser / methods*
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Perioperative Period
  • Postoperative Complications / etiology
  • Postoperative Complications / physiopathology
  • Renal Insufficiency, Chronic / etiology
  • Renal Insufficiency, Chronic / physiopathology
  • Retrospective Studies
  • Severity of Illness Index
  • Treatment Outcome
  • Ureteroscopy / adverse effects
  • Ureteroscopy / methods*