Percutaneous Nephrolithotomy and Chronic Kidney Disease

Results from the CROES PCNL Global Study

Krish Sairam, Cesare M Scoffone, Peter Alken, Burak Turna, Hiren S Sodha, Jorge Rioja, J Stuart Wolf, Jean J M C H de la Rosette, CROES PCNL Study Group, Palle Jørn Sloth Osther

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

PURPOSE: We compared the characteristics and outcomes of patients treated with percutaneous nephrolithotomy in the CROES (Clinical Research Office of the Endourological Society) Global Study according to preoperative renal function. MATERIALS AND METHODS: Prospective data on consecutive patients treated with percutaneous nephrolithotomy in a 1-year period were collected from 96 participating centers. The glomerular filtration rate was estimated using the Modification of Diet in Renal Disease formula based on preoperative serum creatinine measurement. Patients were divided into 3 groups by glomerular filtration rate, including chronic kidney disease stages 0/I/II-greater than 60, stage III-30 to 59 and stages IV/V-less than 30 ml/minute/1.73 m(2). Patient characteristics, operative characteristics, outcomes and morbidity were assessed. RESULTS: Estimated glomerular filtration rate data were available on 5,644 patients, including 4,436 with chronic kidney disease stages 0/I/II, 994 with stage III and 214 with stages IV/V. A clinically significant minority of patients with nephrolithiasis presented with severe chronic kidney disease. A greater number of patients with stages IV/V previously underwent percutaneous nephrolithotomy, ureteroscopy or nephrostomy and had positive urine cultures than less severely affected patients, consistent with the higher incidence of staghorn stones in these patients. Patients with chronic kidney disease stages IV/V had statistically significantly worse postoperative outcomes than those in the other chronic kidney disease groups. CONCLUSIONS: Poor renal function negatively impacts the post-percutaneous nephrolithotomy outcome. By more aggressive removal of kidney stones, particularly staghorn stones, at first presentation and more vigilantly attempting to prevent recurrence through infection control, pharmacological or other interventions, the progression of chronic kidney disease due to nephrolithiasis may be mitigated.
Original languageEnglish
JournalJournal of Urology
Volume188
Issue number4
Pages (from-to)1195-1200
ISSN0022-5347
DOIs
Publication statusPublished - 2012

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Percutaneous Nephrostomy
Research
Glomerular Filtration Rate
Nephrolithiasis
Kidney
Ureteroscopy
Infection Control
Creatinine
Urine

Cite this

Sairam, Krish ; Scoffone, Cesare M ; Alken, Peter ; Turna, Burak ; Sodha, Hiren S ; Rioja, Jorge ; Wolf, J Stuart ; de la Rosette, Jean J M C H ; CROES PCNL Study Group ; Osther, Palle Jørn Sloth. / Percutaneous Nephrolithotomy and Chronic Kidney Disease : Results from the CROES PCNL Global Study. In: Journal of Urology. 2012 ; Vol. 188, No. 4. pp. 1195-1200.
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title = "Percutaneous Nephrolithotomy and Chronic Kidney Disease: Results from the CROES PCNL Global Study",
abstract = "PURPOSE: We compared the characteristics and outcomes of patients treated with percutaneous nephrolithotomy in the CROES (Clinical Research Office of the Endourological Society) Global Study according to preoperative renal function. MATERIALS AND METHODS: Prospective data on consecutive patients treated with percutaneous nephrolithotomy in a 1-year period were collected from 96 participating centers. The glomerular filtration rate was estimated using the Modification of Diet in Renal Disease formula based on preoperative serum creatinine measurement. Patients were divided into 3 groups by glomerular filtration rate, including chronic kidney disease stages 0/I/II-greater than 60, stage III-30 to 59 and stages IV/V-less than 30 ml/minute/1.73 m(2). Patient characteristics, operative characteristics, outcomes and morbidity were assessed. RESULTS: Estimated glomerular filtration rate data were available on 5,644 patients, including 4,436 with chronic kidney disease stages 0/I/II, 994 with stage III and 214 with stages IV/V. A clinically significant minority of patients with nephrolithiasis presented with severe chronic kidney disease. A greater number of patients with stages IV/V previously underwent percutaneous nephrolithotomy, ureteroscopy or nephrostomy and had positive urine cultures than less severely affected patients, consistent with the higher incidence of staghorn stones in these patients. Patients with chronic kidney disease stages IV/V had statistically significantly worse postoperative outcomes than those in the other chronic kidney disease groups. CONCLUSIONS: Poor renal function negatively impacts the post-percutaneous nephrolithotomy outcome. By more aggressive removal of kidney stones, particularly staghorn stones, at first presentation and more vigilantly attempting to prevent recurrence through infection control, pharmacological or other interventions, the progression of chronic kidney disease due to nephrolithiasis may be mitigated.",
author = "Krish Sairam and Scoffone, {Cesare M} and Peter Alken and Burak Turna and Sodha, {Hiren S} and Jorge Rioja and Wolf, {J Stuart} and {de la Rosette}, {Jean J M C H} and {CROES PCNL Study Group} and Osther, {Palle J{\o}rn Sloth}",
note = "Copyright {\circledC} 2012 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.",
year = "2012",
doi = "10.1016/j.juro.2012.06.027",
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Sairam, K, Scoffone, CM, Alken, P, Turna, B, Sodha, HS, Rioja, J, Wolf, JS, de la Rosette, JJMCH, CROES PCNL Study Group & Osther, PJS 2012, 'Percutaneous Nephrolithotomy and Chronic Kidney Disease: Results from the CROES PCNL Global Study', Journal of Urology, vol. 188, no. 4, pp. 1195-1200. https://doi.org/10.1016/j.juro.2012.06.027

Percutaneous Nephrolithotomy and Chronic Kidney Disease : Results from the CROES PCNL Global Study. / Sairam, Krish; Scoffone, Cesare M; Alken, Peter; Turna, Burak; Sodha, Hiren S; Rioja, Jorge; Wolf, J Stuart; de la Rosette, Jean J M C H; CROES PCNL Study Group ; Osther, Palle Jørn Sloth.

In: Journal of Urology, Vol. 188, No. 4, 2012, p. 1195-1200.

Research output: Contribution to journalJournal articleResearchpeer-review

TY - JOUR

T1 - Percutaneous Nephrolithotomy and Chronic Kidney Disease

T2 - Results from the CROES PCNL Global Study

AU - Sairam, Krish

AU - Scoffone, Cesare M

AU - Alken, Peter

AU - Turna, Burak

AU - Sodha, Hiren S

AU - Rioja, Jorge

AU - Wolf, J Stuart

AU - de la Rosette, Jean J M C H

AU - CROES PCNL Study Group

AU - Osther, Palle Jørn Sloth

N1 - Copyright © 2012 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

PY - 2012

Y1 - 2012

N2 - PURPOSE: We compared the characteristics and outcomes of patients treated with percutaneous nephrolithotomy in the CROES (Clinical Research Office of the Endourological Society) Global Study according to preoperative renal function. MATERIALS AND METHODS: Prospective data on consecutive patients treated with percutaneous nephrolithotomy in a 1-year period were collected from 96 participating centers. The glomerular filtration rate was estimated using the Modification of Diet in Renal Disease formula based on preoperative serum creatinine measurement. Patients were divided into 3 groups by glomerular filtration rate, including chronic kidney disease stages 0/I/II-greater than 60, stage III-30 to 59 and stages IV/V-less than 30 ml/minute/1.73 m(2). Patient characteristics, operative characteristics, outcomes and morbidity were assessed. RESULTS: Estimated glomerular filtration rate data were available on 5,644 patients, including 4,436 with chronic kidney disease stages 0/I/II, 994 with stage III and 214 with stages IV/V. A clinically significant minority of patients with nephrolithiasis presented with severe chronic kidney disease. A greater number of patients with stages IV/V previously underwent percutaneous nephrolithotomy, ureteroscopy or nephrostomy and had positive urine cultures than less severely affected patients, consistent with the higher incidence of staghorn stones in these patients. Patients with chronic kidney disease stages IV/V had statistically significantly worse postoperative outcomes than those in the other chronic kidney disease groups. CONCLUSIONS: Poor renal function negatively impacts the post-percutaneous nephrolithotomy outcome. By more aggressive removal of kidney stones, particularly staghorn stones, at first presentation and more vigilantly attempting to prevent recurrence through infection control, pharmacological or other interventions, the progression of chronic kidney disease due to nephrolithiasis may be mitigated.

AB - PURPOSE: We compared the characteristics and outcomes of patients treated with percutaneous nephrolithotomy in the CROES (Clinical Research Office of the Endourological Society) Global Study according to preoperative renal function. MATERIALS AND METHODS: Prospective data on consecutive patients treated with percutaneous nephrolithotomy in a 1-year period were collected from 96 participating centers. The glomerular filtration rate was estimated using the Modification of Diet in Renal Disease formula based on preoperative serum creatinine measurement. Patients were divided into 3 groups by glomerular filtration rate, including chronic kidney disease stages 0/I/II-greater than 60, stage III-30 to 59 and stages IV/V-less than 30 ml/minute/1.73 m(2). Patient characteristics, operative characteristics, outcomes and morbidity were assessed. RESULTS: Estimated glomerular filtration rate data were available on 5,644 patients, including 4,436 with chronic kidney disease stages 0/I/II, 994 with stage III and 214 with stages IV/V. A clinically significant minority of patients with nephrolithiasis presented with severe chronic kidney disease. A greater number of patients with stages IV/V previously underwent percutaneous nephrolithotomy, ureteroscopy or nephrostomy and had positive urine cultures than less severely affected patients, consistent with the higher incidence of staghorn stones in these patients. Patients with chronic kidney disease stages IV/V had statistically significantly worse postoperative outcomes than those in the other chronic kidney disease groups. CONCLUSIONS: Poor renal function negatively impacts the post-percutaneous nephrolithotomy outcome. By more aggressive removal of kidney stones, particularly staghorn stones, at first presentation and more vigilantly attempting to prevent recurrence through infection control, pharmacological or other interventions, the progression of chronic kidney disease due to nephrolithiasis may be mitigated.

U2 - 10.1016/j.juro.2012.06.027

DO - 10.1016/j.juro.2012.06.027

M3 - Journal article

VL - 188

SP - 1195

EP - 1200

JO - Journal of Urology

JF - Journal of Urology

SN - 0022-5347

IS - 4

ER -