Percutaneous nephrolithotomy in patients with normal versus impaired renal function

This study aimed to compare the results of percutaneous nephrolithotomy (PCNL) in patients with impaired renal function (IRF) and normal renal function (NRF). Records of 300 consecutive patients who underwent PCNL from July 2002 to July 2005 were retrospectively reviewed. Nineteen patients (6.3%) had serum creatinine values higher than 1.5 mg/dl before surgery (IRF Group). Nineteen gender and age matched patients with normal renal function were chosen as controls (NRF Group). The surgical parameters, outcome, and complication rates were compared. The effect of PCNL on the renal function was assessed in patients with IRF. There were 13 male and 6 female patients in both groups. In the IRF group, seven patients had a solitary kidney and three had bilateral stones. Thus, PCNL was performed on 22 kidneys. No patients in the NRF Group had solitary kidney or bilateral stones and PCNL was performed on 19 kidneys. There were no statistically significant differences between the two groups for success and complication rates (P = 0.376 and P = 0.184, respectively). In a mean follow-up of 15.6 months, mean serum creatinine decreased from 2.8 to 2.6 mg/dl (P = 0.273) in patients of the IRF group. Similar stone clearance and complication rates were obtained with PCNL in patients with impaired and normal renal function. Surgery does not cause biochemical deterioration in patients with compromised renal function before treatment.