Research On Influence Factors Of Functional Outcome After PCNL In Urolithiasis Patients With Solitary Kidney

Objective:We assess the factors which may have impact on the renal function in the urolithiasis patients with solitary kidneys who have treated by mPCNL. The result may be helpful to our clinical work.Materials and Methods:A total of73urolithiasis patients(40men and33women) who have solitary kidneys have involved this study. All the patients treated by mPCNL in Xiangya Hospital, Central South University during March2012to May2013. Patients were underwent a1year follow-up and divided into2groups according to the GFR change. One group includes patients whose GFR at1year after mPCNL was decline more than5%compare with preopration, named Group of Deterioration. The other group includes the rest of patients named Group of Stablization or Improvement. Observation target includes age, sex, BMI, surgical history, combined diseases, preoperative renal cortical thickness, urine routines and culture, operation time and blood loss volume. Univariate and multivariate statistical analysis was done.Results:47patients showed stablization or improvement in renal function by1year follow-up while26showed deterioration. Stone-free rate was84.9%. Hypertension(B=1.262,OR=3.533), proteinuria(B=1.607, OR=4.990), urinary tract infection(B=1.751, OR=5.763) and preoperative renal cortical thickness (B=-1.233, OR=0.292) were significant predictors of subsequent renal function deterioration.Conclusion:renal function deterioration after mPCNL was impacted by many factors. Hypertension, proteinuria, urinary tract infection may act as risk factors while preoperative renal cortical thickness act as a protective factor.