1814 EFFICIENCY OF FLEXIBLE URETERORENOSCOPY IN TREATMENT OF KIDNEY STONES IN PATIENTS WITH CHRONIC KIDNEY DISEASE

Abstract

You have accessJournal of UrologyStone Disease: SWL, Ureteroscopy or Percutaneous Stone Removal (III)1 Apr 20131814 EFFICIENCY OF FLEXIBLE URETERORENOSCOPY IN TREATMENT OF KIDNEY STONES IN PATIENTS WITH CHRONIC KIDNEY DISEASE Emrah Yuruk, Murat Binbay, Faruk Ozgor, Akif Erbin, Yalcin Berberoglu, and Ahmet Yaser Muslumanoglu Emrah YurukEmrah Yuruk Istanbul, Turkey More articles by this author , Murat BinbayMurat Binbay Istanbul, Turkey More articles by this author , Faruk OzgorFaruk Ozgor Istanbul, Turkey More articles by this author , Akif ErbinAkif Erbin Istanbul, Turkey More articles by this author , Yalcin BerberogluYalcin Berberoglu Istanbul, Turkey More articles by this author , and Ahmet Yaser MuslumanogluAhmet Yaser Muslumanoglu Istanbul, Turkey More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.2177AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES We evaluated the effects of kidney stone treatment with flexible ureterorenoscopy (f-URS) on patients with chronic kidney disease. METHODS Data of patients who underwent ureterorenoscopic kidney stone treatment were collected. Estimated glomerular filtration rate (eGFR) was calculated using chronic kidney disease epidemiology collaboration (CKD-EPI) formula for each patient. Patients were staged according to eGFR using National Kidney Foundation guidelines. Stage 3 and more was accepted as chronic kidney disease (CKD). Operative findings, postoperative complications and 3rd month success rates as well as overall eGFR change were documented. Success was evaluated with non-contrast enhanced computerized tomography in all cases. RESULTS Overall 339 patients were treated and 62 of them had stage 3 or more CKD. Male/female ratio was 24/38. Mean patient age was 56.79±11.45 (range: 14-80) years. Co-morbidities including hypertension, diabetes mellitus, chronic heart or lung disease were seen in 43 patients. Previous stone intervention including percutaneous nephrolithotomy and shock-wave lithotripsy was performed in 39 patients and 11 had solitary kidney. Mean stone size was 173.56±102.08 (range: 66-620) mm2. Stones were located in upper calyx in 7, middle calyx in 7, lower pole in 18, pelvis in 6, and multiple calyx in 24 patients. Operative time was 49.08±25.76 (range: 12-135) minutes. Fluoroscopic screening time was 2.90±2.05 (range: 0.5-15) minutes. Access sheath was used in 54 patients. Overall complications were seen in 12 patients. Mucosal tearing was seen in 8 patients and was the most common complication. Postoperative complications were also seen in 12 patients and colicky pain was the most common postoperative complication accounting in 9 patients. DJ catheter was used in 59 patients. Preoperative mean eGFR rate was 48.16±8.71 (range: 19-59) ml/min/1.73m2 and mean CKD stage was 3.01±0.12. Early postoperative mean eGFR and CKD stage was 49.0±11.71 (range: 17-72) ml/min/1.73m2 and 2.80±0.43, respectively while mean eGFR increased to 53.98±9.06 (range: 35-73) ml/min/1.73m2, and mean CKD stage decreased to 2.64±0.51 at 3rd month control. After the surgery, 40 patients were stone free while 14 had fragments less than 2mm in largest diameter. 8 patients had postoperative auxiliary treatment. Hospitalization time was 25.70±25.62 (range: 7-180) hours. At 3rd month control, 12 more patients were stone free and overall 83.8% SF rate was achieved with only one session fURS. CONCLUSIONS Flexible ureterorenoscopy, as in normal population, can be safely and effectively be used in chronically diseased kidneys. Although eGFR remains stable at the end of first week, the overall kidney function gets better at 3rd month control. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e746 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Emrah Yuruk Istanbul, Turkey More articles by this author Murat Binbay Istanbul, Turkey More articles by this author Faruk Ozgor Istanbul, Turkey More articles by this author Akif Erbin Istanbul, Turkey More articles by this author Yalcin Berberoglu Istanbul, Turkey More articles by this author Ahmet Yaser Muslumanoglu Istanbul, Turkey More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...