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Acute kidney injury and percutaneous nephrolithotomy: incidence and predictive factors

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Abstract

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 < 0.001).

Conclusions

Perioperative AKI occurs in 4.4% of patients undergoing PCNL. Preoperative hemoglobin and serum creatinine can identify those at increased risk, in whom it may be important to avoid nephrotoxic agents.

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Funding

This study received no financial support of any kind.

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Authors and Affiliations

  1. Glickman Urological and Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH, USA

    Juan Fulla, Phornphen Prasanchaimontri, Henry C. Wright, Marlie Elia, Smita De & Juan Calle

  2. Department of Surgery, Ratchaburi Hospital, Ratchaburi, Thailand

    Phornphen Prasanchaimontri

  3. Department of Urology, UCSD, San Diego, CA, USA

    Manoj Monga

  4. Department of Urology, University of Chile, Santa Rosa 1234, Santiago, Chile

    Juan Fulla

Authors
  1. Juan Fulla
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  2. Phornphen Prasanchaimontri
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  3. Henry C. Wright
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  4. Marlie Elia
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  5. Smita De
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  6. Manoj Monga
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  7. Juan Calle
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Contributions

JF: protocol/project development; data collection or management; data analysis; manuscript writing/editing. PP: data analysis. HW: manuscript writing/editing. ME: data collection or management. SD: manuscript writing/editing. MM: manuscript writing/editing. JC: manuscript writing/editing.

Corresponding author

Correspondence to Juan Calle.

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Fulla, J., Prasanchaimontri, P., Wright, H.C. et al. Acute kidney injury and percutaneous nephrolithotomy: incidence and predictive factors. World J Urol 40, 563–567 (2022). https://doi.org/10.1007/s00345-021-03874-4

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  • DOI: https://doi.org/10.1007/s00345-021-03874-4

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