Research Article
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Böbrek Taşı Tedavisinde Retrograd Intrarenal Cerrahinin Böbrek Fonksiyonuna Etkisi

Year 2021, Volume: 5 Issue: 1, 55 - 60, 23.04.2021

Volkan Selmi Sercan Sarı Ünal Öztekin Mehmet Caniklioğlu Levent Işıkay

https://doi.org/10.30565/medalanya.792118

Abstract

Amaç: Bu çalışmada, Retrograd İntrarenal Cerrahi sonrasında eGFR’yi analiz eder-ek böbrek fonksiyonundaki değişikliği değerlendirmeyi ve değişikliği etkileyen fak-törleri sunmayı amaçladık.


Yöntem: Mayıs 2018 ile Şubat 2019 arasında böbrek taşı nedeniyle RIRS yapılan 88 hastayı prospektif olarak analiz ettik. eGFR, ameliyat öncesi, ameliyat sonrası ilk gün, ameliyat sonrası ilk ay ve ameliyat sonrası üçüncü ayda MDRD formülü ile he-saplandı. Tüm veriler takip formuna kaydedildi. Tüm işlemler genel anestezi altında yapıldı.


Bulgular: Çalışmanın taşsızlık oranı %79,5 idi. Preoperatif eGFR 99,86 mL/da-k/1.73m2 idi. eGFR, postoperatif ilk günde 101.80 mL/dak/1,73m2 ve üçüncü ay takibinde 111,66 mL/dak/1,73m2 olarak hesaplandı. eGFR'deki değişiklik erken dönemde 1,94 mL/dak/1,73m2 ve uzun dönem takip döneminde 11,8 mL/dak/1,73m2 idi. Üçüncü ay takiplerinde preoperatif böbrek fonksiyonuna göre ve erken döneme göre eGFR'de istatistiksel olarak anlamlı bir iyileşme vardı.


Sonuç: Eski taş çıkarma yöntemlerinin aksine RIRS, postoperatif böbrek fonksiy-onunda stabilizasyon sağlayabilmektedir. Hatta preoperatif böbrek fonksiyonu bozuk olan hastalarda operasyon sonrası böbrek fonksiyonlarında düzelmeye yardımcı ola-bilmektedir. Ürologlar, ameliyat sonrası böbrek fonksiyonlarında iyileşme olmasını istedikleri hastalarda RIRS seçeneğini akılda tutabilirler.


Keywords

Üreteroskopi, litotripsi, böbrek, fonksiyon,

Supporting Institution

yok

Project Number

yok

Thanks

yok

References

  • 1. EAU Guidelines. Edn. presented at the EAU Annual Congress Amsterdam 2020. ISBN 978-94-92671-07-3.
  • 2. Schnabel MJ, Gierth M, Chaussy CG, Dötzer K, Burger M, Fritsche HM. Incidence and risk factors of renal hematoma: a prospective study of 1,300 SWL treatments. Urolithiasis. 2014 Jun;42(3):247-53. doi: 10.1007/s00240-014-0637-4.
  • 3. Mukherjee S, Sinha RK, Jindal T, Sharma PK, Mandal SN, Karmakar D. Short-term Alteration of Renal Function and Electrolytes after Percutaneous Nephrolithotomy. Urol J. 2019 Dec 24;16(6):530-535. doi: 10.22037/uj.v0i0.4558.
  • 4. Yadav R, Agarwal S, Sankhwar S, Goel A, Kumar M, Singh M, et al. A prospective study evaluating impact on renal function following percutaneous nephrolithotomy using Tc99m ethylenedicysteine renal scan: Does multiplicity of access tracts play a role? Investig Clin Urol. 2019 Jan;60(1):21-28. doi: 10.4111/icu.2019.60.1.21.
  • 5. Pirola GM, Micali S, Sighinolfi MC, Martorana E, Territo A, Puliatti S, et al. Evaluation of long-term side effects after shock-wave lithotripsy for renal calculi using a third generation electromagnetic lithotripter. Urolithiasis. 2016 Oct;44(5):465-70. doi: 10.1007/s00240-016-0867-8.
  • 6. El-Tabey NA, El-Nahas AR, Eraky I, Shoma AM, El-Assmy AM, Soliman SA, et al. Long-term functional outcome of percutaneous nephrolithotomy in solitary kidney. Urology. 2014 May;83(5):1011-5. doi: 10.1016/j.urology.2013.12.025.
  • 7. Bayrak O, Seckiner I, Erturhan SM, Mizrak S, Erbagci A. Analysis of changes in the glomerular filtration rate as measured by the cockroft-gault formula in the early period after percutaneous nephrolithotomy. Korean J Urol. 2012 Aug;53(8):552-5. doi: 10.4111/kju.2012.53.8.552.
  • 8. Sheir KZ, Gad HM. Prospective study of the effects of shock wave lithotripsy on renal function: role of post-shock wave lithotripsy obstruction. Urology. 2003 Jun;61(6):1102-6. doi: 10.1016/s0090-4295(03)00265-6.
  • 9. Traxer O, Thomas A. Prospective evaluation and classification of ureteral wall injuries resulting from insertion of a ureteral access sheath during retrograde intrarenal surgery. J Urol. 2013 Feb;189(2):580-4. doi: 10.1016/j.juro.2012.08.197.
  • 10. Jung H, Osther PJ. Intraluminal pressure profiles during flexible ureterorenoscopy. Springerplus. 2015 Jul 24;4:373. doi: 10.1186/s40064-015-1114-4.
  • 11. Wood K, Keys T, Mufarrij P, Assimos DG. Impact of stone removal on renal function: a review. Rev Urol. 2011;13(2):73-89. PMID: 21935339. 12. Zhe M, Hang Z. Nephrolithiasis as a risk factor of chronic kidney disease: a meta-analysis of cohort studies with 4,770,691 participants. Urolithiasis. 2017 Oct;45(5):441-448. doi: 10.1007/s00240-016-0938-x.
  • 13. Oztekin U, Erkoc F, Sari S, Selmi V, Gurel A, Atac F. The Effect of Ureterorenoscopy and Retrograde Intrarenal Surgery Procedures on Renovascular Hemodynamics. Ann Clin Anal Med 2020;11(4):272-276 doi: 10.4328/ACAM.20066.
  • 14. Nishi M, Matsumoto K, Fujita T, Iwamura M. Improvement in Renal Function and Symptoms of Patients Treated with Laparoscopic Pyeloplasty for Ureteropelvic Junction Obstruction with Less Than 20% Split Renal Function. J Endourol. 2016 Nov;30(11):1214-1218. doi: 10.1089/end.2016.0553.
  • 15. Ertaş K, Temiz MZ, Çolakerol A, Küçük SH, Şahan A, Yürük E. Effects of flexible ureteroscopy on kidney: A prospective clinical trial. Turk J Urol. 2020 Mar 11;46(4):297–302. doi: 10.5152/tud.2020.19195.
  • 16. Hoarau N, Martin F, Lebdai S, Chautard D, Culty T, Azzouzi AR, et al. Impact of retrograde flexible ureteroscopy and intracorporeal lithotripsy on kidney functional outcomes. Int Braz J Urol. 2015 Sep-Oct;41(5):920-6. doi: 10.1590/S1677-5538.IBJU.2014.0402.
  • 17. Demirtaş A, Caniklioğlu M, Kula M, Sofikerim M, Akınsal EC, Ergül MA, et al. Assessment of the effects of access count in percutaneous nephrolithotomy on renal functions by technetium-99m-dimercaptosuccinic Acid scintigraphy. ISRN Urol. 2013 May 8;2013:827121. doi: 10.1155/2013/827121.
  • 18. Reeves T, Pietropaolo A, Somani BK. Ureteroscopy and Laser Stone Fragmentation Is Safe and Tends to Improve Renal Function in Patients with Chronic Kidney Disease: Prospective Outcomes with a Minimum Follow-Up of 6 Months. J Endourol. 2020 Apr;34(4):423-428. doi: 10.1089/end.2019.0784.
  • 19. Desai MM, Grover R, Aron M, Ganpule A, Joshi SS, Desai MR, et al. Robotic flexible ureteroscopy for renal calculi: initial clinical experience. J Urol. 2011 Aug;186(2):563-8. doi: 10.1016/j.juro.2011.03.128.
  • 20. Lee DI, Bagley DH. Long-term effects of ureteroscopic laser lithotripsy on glomerular filtration rate in the face of mild to moderate renal insufficiency. J Endourol. 2001 Sep;15(7):715-7. doi: 10.1089/08927790152596307.
  • 21. Piao S, Park J, Son H, Jeong H, Cho SY. Evaluation of renal function in patients with a main renal stone larger than 1 cm and perioperative renal functional change in minimally invasive renal stone surgery: a prospective, observational study. World J Urol. 2016 May;34(5):725-32. doi: 10.1007/s00345-015-1653-x.

The Effect of Retrograde Intrarenal Surgery on Kidney Function in Renal Stone Treatment

Year 2021, Volume: 5 Issue: 1, 55 - 60, 23.04.2021

Volkan Selmi Sercan Sarı Ünal Öztekin Mehmet Caniklioğlu Levent Işıkay

https://doi.org/10.30565/medalanya.792118

Abstract

Aim: In this study, we aimed to evaluate the alteration in renal function by analyzing the estimated glomerular filtration rate after Retrograde Intrarenal Surgery, and pres-ent the factors which have an impact on alteration.


Methods: We analyzed 88 patients who underwent RIRS for renal stones between May 2018 and February 2019, prospectively. Estimated glomerular filtration rate was calculated by modification of diet in renal disease (MDRD) formula preoperatively, on the first postoperative day, on the first postoperative month and the third post-operative month. All data was recorded on the follow-up form. All procedures were performed under general anesthesia.


Results: The stone-free rate of the study was 79.5%. Preoperative eGFR was 99.86 mL/min/1.73m2 for the study group. The eGFR was calculated 101.80 mL/min/1.73m2 on the first postoperative day and 111.66 mL/min/1.73m2 on the third-month fol-low-up. The change in eGFR was 1.94 mL/min/1.73m2 in the early period and 11.8 mL/min/1.73m2 in the long-term follow-up period. There was a statistically significant improvement in eGFR in the long-term follow-up period than the early period when compared to preoperative renal function.


Conclusion: On the contrary of former stone removal modalities, RIRS can stabilize postoperative kidney function. It may even help improve postoperative kidney func-tion in patients with preoperative renal dysfunction. Urologists may keep in mind the RIRS option in patients with this condition.


Keywords

Ureteroscopy, lithotripsy, kidney, function,

Project Number

yok

References

  • 1. EAU Guidelines. Edn. presented at the EAU Annual Congress Amsterdam 2020. ISBN 978-94-92671-07-3.
  • 2. Schnabel MJ, Gierth M, Chaussy CG, Dötzer K, Burger M, Fritsche HM. Incidence and risk factors of renal hematoma: a prospective study of 1,300 SWL treatments. Urolithiasis. 2014 Jun;42(3):247-53. doi: 10.1007/s00240-014-0637-4.
  • 3. Mukherjee S, Sinha RK, Jindal T, Sharma PK, Mandal SN, Karmakar D. Short-term Alteration of Renal Function and Electrolytes after Percutaneous Nephrolithotomy. Urol J. 2019 Dec 24;16(6):530-535. doi: 10.22037/uj.v0i0.4558.
  • 4. Yadav R, Agarwal S, Sankhwar S, Goel A, Kumar M, Singh M, et al. A prospective study evaluating impact on renal function following percutaneous nephrolithotomy using Tc99m ethylenedicysteine renal scan: Does multiplicity of access tracts play a role? Investig Clin Urol. 2019 Jan;60(1):21-28. doi: 10.4111/icu.2019.60.1.21.
  • 5. Pirola GM, Micali S, Sighinolfi MC, Martorana E, Territo A, Puliatti S, et al. Evaluation of long-term side effects after shock-wave lithotripsy for renal calculi using a third generation electromagnetic lithotripter. Urolithiasis. 2016 Oct;44(5):465-70. doi: 10.1007/s00240-016-0867-8.
  • 6. El-Tabey NA, El-Nahas AR, Eraky I, Shoma AM, El-Assmy AM, Soliman SA, et al. Long-term functional outcome of percutaneous nephrolithotomy in solitary kidney. Urology. 2014 May;83(5):1011-5. doi: 10.1016/j.urology.2013.12.025.
  • 7. Bayrak O, Seckiner I, Erturhan SM, Mizrak S, Erbagci A. Analysis of changes in the glomerular filtration rate as measured by the cockroft-gault formula in the early period after percutaneous nephrolithotomy. Korean J Urol. 2012 Aug;53(8):552-5. doi: 10.4111/kju.2012.53.8.552.
  • 8. Sheir KZ, Gad HM. Prospective study of the effects of shock wave lithotripsy on renal function: role of post-shock wave lithotripsy obstruction. Urology. 2003 Jun;61(6):1102-6. doi: 10.1016/s0090-4295(03)00265-6.
  • 9. Traxer O, Thomas A. Prospective evaluation and classification of ureteral wall injuries resulting from insertion of a ureteral access sheath during retrograde intrarenal surgery. J Urol. 2013 Feb;189(2):580-4. doi: 10.1016/j.juro.2012.08.197.
  • 10. Jung H, Osther PJ. Intraluminal pressure profiles during flexible ureterorenoscopy. Springerplus. 2015 Jul 24;4:373. doi: 10.1186/s40064-015-1114-4.
  • 11. Wood K, Keys T, Mufarrij P, Assimos DG. Impact of stone removal on renal function: a review. Rev Urol. 2011;13(2):73-89. PMID: 21935339. 12. Zhe M, Hang Z. Nephrolithiasis as a risk factor of chronic kidney disease: a meta-analysis of cohort studies with 4,770,691 participants. Urolithiasis. 2017 Oct;45(5):441-448. doi: 10.1007/s00240-016-0938-x.
  • 13. Oztekin U, Erkoc F, Sari S, Selmi V, Gurel A, Atac F. The Effect of Ureterorenoscopy and Retrograde Intrarenal Surgery Procedures on Renovascular Hemodynamics. Ann Clin Anal Med 2020;11(4):272-276 doi: 10.4328/ACAM.20066.
  • 14. Nishi M, Matsumoto K, Fujita T, Iwamura M. Improvement in Renal Function and Symptoms of Patients Treated with Laparoscopic Pyeloplasty for Ureteropelvic Junction Obstruction with Less Than 20% Split Renal Function. J Endourol. 2016 Nov;30(11):1214-1218. doi: 10.1089/end.2016.0553.
  • 15. Ertaş K, Temiz MZ, Çolakerol A, Küçük SH, Şahan A, Yürük E. Effects of flexible ureteroscopy on kidney: A prospective clinical trial. Turk J Urol. 2020 Mar 11;46(4):297–302. doi: 10.5152/tud.2020.19195.
  • 16. Hoarau N, Martin F, Lebdai S, Chautard D, Culty T, Azzouzi AR, et al. Impact of retrograde flexible ureteroscopy and intracorporeal lithotripsy on kidney functional outcomes. Int Braz J Urol. 2015 Sep-Oct;41(5):920-6. doi: 10.1590/S1677-5538.IBJU.2014.0402.
  • 17. Demirtaş A, Caniklioğlu M, Kula M, Sofikerim M, Akınsal EC, Ergül MA, et al. Assessment of the effects of access count in percutaneous nephrolithotomy on renal functions by technetium-99m-dimercaptosuccinic Acid scintigraphy. ISRN Urol. 2013 May 8;2013:827121. doi: 10.1155/2013/827121.
  • 18. Reeves T, Pietropaolo A, Somani BK. Ureteroscopy and Laser Stone Fragmentation Is Safe and Tends to Improve Renal Function in Patients with Chronic Kidney Disease: Prospective Outcomes with a Minimum Follow-Up of 6 Months. J Endourol. 2020 Apr;34(4):423-428. doi: 10.1089/end.2019.0784.
  • 19. Desai MM, Grover R, Aron M, Ganpule A, Joshi SS, Desai MR, et al. Robotic flexible ureteroscopy for renal calculi: initial clinical experience. J Urol. 2011 Aug;186(2):563-8. doi: 10.1016/j.juro.2011.03.128.
  • 20. Lee DI, Bagley DH. Long-term effects of ureteroscopic laser lithotripsy on glomerular filtration rate in the face of mild to moderate renal insufficiency. J Endourol. 2001 Sep;15(7):715-7. doi: 10.1089/08927790152596307.
  • 21. Piao S, Park J, Son H, Jeong H, Cho SY. Evaluation of renal function in patients with a main renal stone larger than 1 cm and perioperative renal functional change in minimally invasive renal stone surgery: a prospective, observational study. World J Urol. 2016 May;34(5):725-32. doi: 10.1007/s00345-015-1653-x.
There are 20 citations in total.

Details

Primary Language English
Subjects Surgery
Journal Section Research Article
Authors

Volkan Selmi 0000-0003-2605-9935

Sercan Sarı 0000-0002-0994-3799

Ünal Öztekin 0000-0001-9568-9442

Mehmet Caniklioğlu 0000-0003-2216-5677

Levent Işıkay 0000-0001-6345-0189

Project Number yok
Publication Date April 23, 2021
Submission Date September 8, 2020
Acceptance Date December 4, 2020
Published in Issue Year 2021 Volume: 5 Issue: 1

Cite

Vancouver Selmi V, Sarı S, Öztekin Ü, Caniklioğlu M, Işıkay L. The Effect of Retrograde Intrarenal Surgery on Kidney Function in Renal Stone Treatment. Acta Med. Alanya. 2021;5(1):55-60.

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