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Outcomes of ultrasound‐guided percutaneous nephrolithotomy for the treatment of large stones within non‐functioning atrophic kidneys
Author(s) -
Su Boxing,
Ji Chaoyue,
Li Jianxing,
Xiao Bo,
Chen Song,
Tang Yuzhe,
Liu Yubao,
Fu Meng,
Bai Wenjie,
Hu Weiguo
Publication year - 2021
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1111/iju.14440
Subject(s) - medicine , percutaneous nephrolithotomy , urinary system , surgery , complication , renal function , diabetes mellitus , percutaneous , urology , nephrostomy , endocrinology
Objectives To evaluate outcomes in patients who underwent total ultrasound‐guided percutaneous nephrolithotomy for the management of large stones (>2 cm) within non‐functioning atrophic kidneys, and to identify risk factors associated with postoperative persistence of urinary tract infection symptoms in such patients. Methods Between December 2014 and May 2019, 56 patients with large stones within non‐functioning atrophic kidneys were treated at Beijing Tsinghua Changgung Hospital, Beijing, China, with total ultrasound‐guided percutaneous nephrolithotomy. Factors including age, sex, previous medical history, stone burden, stone composition, stone‐free rate, complication rate and postoperative urinary tract infection symptoms were retrospectively evaluated. Uni‐ and multivariate analyses were carried out to identify risk factors that predict persistence of urinary tract infection symptoms after percutaneous nephrolithotomy in such patients. Results The final stone‐free rate after auxiliary treatments was 87.5%. The overall complication rate was 17.9%. After a median follow‐up period of 12 months (range 6–40 months), three patients (5.4%) ultimately underwent nephrectomy. A total of 44 patients (78.6%) had no symptoms of urinary tract infection during follow up, whereas 63.6% of patients with diabetes continued to show persistent urinary tract infection symptoms at the latest follow up. Five patients (8.9%) showed improved total renal function, while most patients (83.9%) showed a stable estimated glomerular filtration rate. Diabetes was the only factor showing statistical significance in both univariate and multivariate analyses that predicted persistence of urinary tract infection symptoms after treatment with percutaneous nephrolithotomy. Conclusions Ultrasound‐guided percutaneous nephrolithotomy is a safe and feasible procedure that can be carried out in patients with large stones within non‐functioning atrophic kidneys. However, for such patients with diabetes, percutaneous nephrolithotomy is not recommended.