Research Journal of Medical Sciences
ISSN: Online 1993-6095ISSN: Print 1815-9346
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Assessing Functional Outcomes of Performing Per Cutaneous Nephrolithotomy in Chronic Kidney Disease Patients: A Prospective Study
Apurv Shukla, Partha Pratim Mondal, Sudipta Kumar Singh, Shashi Kant Tewary and Arvind
Page: 598-602 | Received 25 Oct 2024, Published online: 30 Dec 2024
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Abstract
The Kidney Disease Outcomes Quality Initiative (K/DOQI) Advisory Board defines chronic kidney disease (CKD), a prevalent public health concern, as renal impairment that lasts longer than three months and results in a GFR below 60mL/min/1.73 m2. To assess PCNL's functional results for calculi in solitary functioning kidney with CKD/ bilateral renal calculi. And to determine the variables influencing renal replacement treatment in CKD patients after PCNL. The study is prospective in nature. A 4‐variable MDRD equation was used to determine each patient's eGFR. One day prior to surgery, pre‐PCNL serum creatinine and eGFR measurements were performed. For obstructed and contaminated systems, per cutaneous nephrostomy (PCN) or double‐‐J (DJ) stenting was performed. After stabilization, prone PCNL was done on each patient. The measurements taken at the 6‐month follow‐up visit were compared to the preoperative CKD stage and eGFR. Based on changes in their CKD (eGFR) status, patients were split into two groups: Group 1 had improved or stable disease, while Group 2 had worsening disease. By contrasting the two groups, the impact of independent variables on kidney function following PCNL was assessed. The average preoperative eGFR (mean±s.d.) for patients in Group 1 was 32.48±7.52. Additionally, the patients' mean post‐operative eGFR (mean±s.d.) was 40.66±7.13. Group 2 patients had mean preoperative eGFR (mean±s.d.) of 32.00±10.82 and postoperative eGFR (mean±s.d.) of 25.05±8.88. The mean post‐operative eGFR distribution by group was statistically significant (p<0.0001). Following surgery, the CKD stage and eGFR status of 12 patients with stage 4 CKD improved. However, eGFR improved in 30, 4 and 1 individuals with CKD stages 3, 4 and 5, respectively, without causing CKD stage migration. Both eGFR and CKD stage worsened in two patients with CKD stages 3 and 4. We came to the conclusion that one practical way to treat kidney stones in individuals with chronic kidney disease (CKD) is to perform per cutaneous nephrolithotomy (PCNL). Additionally, our findings demonstrated that most patients' renal function improved or stabilized following stone removal. This improvement was observed more often in mild to moderate CKD. With the appropriate management of perioperative complications and comorbidities may further improve the outcome in such patients.
How to cite this article:
Apurv Shukla, Partha Pratim Mondal, Sudipta Kumar Singh, Shashi Kant Tewary and Arvind . Assessing Functional Outcomes of Performing Per Cutaneous Nephrolithotomy in Chronic Kidney Disease Patients: A Prospective Study.
DOI: https://doi.org/10.36478/10.36478/makrjms.2024.12.598.602
URL: https://www.makhillpublications.co/view-article/1815-9346/10.36478/makrjms.2024.12.598.602