Acute kidney injury and percutaneous nephrolithotomy: incidence and predictive factors

Introduction and objective Percutaneous nephrolithotomy (PCNL) is the treatment of choice for patients with large stones. The risk of acute kidney injury (AKI) has not been reported in the Western world. Our objective was to assess the frequency of AKI in patients undergoing PCNL and to identify ind...

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Bibliographic Details
Published in:World journal of urology 2022-02, Vol.40 (2), p.563-567
Main Authors: Fulla, Juan, Prasanchaimontri, Phornphen, Wright, Henry C., Elia, Marlie, De, Smita, Monga, Manoj, Calle, Juan
Format: Article
Language:English
Subjects:
Acute Kidney Injury - epidemiology
Acute Kidney Injury - etiology
Adult
Aged
Confidence intervals
Creatinine
Hemoglobin
Humans
Incidence
Kidneys
Medicine
Medicine & Public Health
Middle Aged
Nephrolithotomy, Percutaneous - adverse effects
Nephrology
Odds Ratio
Oncology
Original Article
Patients
Postoperative Complications - epidemiology
Retrospective Studies
Risk Factors
Statistical analysis
Urological surgery
Urology
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Summary:Introduction and objective Percutaneous nephrolithotomy (PCNL) is the treatment of choice for patients with large stones. The risk of acute kidney injury (AKI) has not been reported in the Western world. Our objective was to assess the frequency of AKI in patients undergoing PCNL and to identify independent predictors of AKI. Methods A retrospective review of PCNL cases performed between January 2014 and June 2019 was reformed. Demographic, laboratory, and intraoperative date were obtained. Perioperative AKI was defined as (1) Increase in serum creatinine by ≥ 0.3 mg/dL (≥ 26.5 micromol/L) within 48 h, or (2) increase in serum creatinine to ≥ 1.5 times baseline. Multivariable logistic regression analysis was performed to determine the factors influencing AKI. A p value of 0.05 was considered significant. Results A total of 566 patients were included. Mean age was 58 ± 14.4 years. The frequency of AKI was 4.4% ( n  = 25). The risk factors for AKI after PCNL were having a baseline creatinine > 1.54 mg/dl ( p  = 0.03, odds ratio [OR] = 2.66, confidence interval [CI] = 1.07–6.6), and a preoperative hemoglobin of less than 10.6 g/dL ( p  = 0.02, odds ratio [OR] = 2.47, confidence interval [CI] = 1.09–5.5). Patients without AKI had a median hospitalization of 2 days, while those with an AKI were hospitalized for a median of 3 days, and this difference was statistically significant ( p  
ISSN:0724-4983
1433-8726
DOI:10.1007/s00345-021-03874-4