Abstract
Editorial Comment: Ureteroscopy is now the most commonly performed stone removing procedure in North America and other regions of the world. Flexible ureteroscopy is commonly done in patients with proximal ureteral and renal stones. These instruments are fragile and costs for repairs/ replacements are high. The use of disposable ureteroscopes has been proposed for limiting costs. These investigators used a device composed of a single use multilumen catheter and a reusable optic fiber. Their outcomes for treating patients with proximal ureteral and renal stones were solid. However, they did not perform an economic analysis. The usefulness of disposable flexible endoscopes will need to be carefully assessed based on clinical as well as economic effectiveness.
Highlights
ObjectiveThe 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
Retrograde intrarenal surgery (RIRS), combined with Holmium laser lithotripsy is widely applied for the management of intra-renal stones
Concerning evaluation of the Glomerular Filtration Rate (GFR), we focused on pre-operative, early post-operative and long-term blood creatinine level measurement
Summary
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. A change toward a less or a more favorable GFR group following RIRS was considered significant. 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; special attention should be given to patients with multiple procedures and preoperative chronic kidney disease. Submitted for publication: August 08, 2014 Accepted after revision: December 04, 2014
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