Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Mar;41(3):857-864.
doi: 10.1007/s00345-023-04301-6. Epub 2023 Jan 31.

Influencing factors of acute kidney injury following retrograde intrarenal surgery

Yunus Emre Göger  1 , Mehmet Serkan Özkent  2 , Muzaffer Tansel Kılınç  3 , Eren Erol  1 , Hakan Hakkı Taşkapu  1
Affiliations

Influencing factors of acute kidney injury following retrograde intrarenal surgery

Yunus Emre Göger et al. World J Urol. 2023 Mar.

Abstract

Purpose: To investigate the influencing factors of acute kidney injury (AKI) following retrograde intrarenal surgery (RIRS).

Methods: The data of patients who underwent RIRS for kidney stones between January 2018 and June 2022 at two tertiary centers were retrospectively analyzed. Demographic data of patients were obtained. According to kidney disease: Improving Global Outcomes (KDIGO) criteria, those with and without AKI were divided into two groups. Preoperative, intraoperative, and postoperative predictive factors of patients were investigated between the groups. In addition, the influencing factors of AKI were examined by multivariate analysis.

Results: This study included 295 (35.7%) women and 532 (64.3%) men. The mean age was 50.03 ± 15.4 years (range 18-89), and mean stone size was 15.5 ± 6.1 mm (range 6-47). Overall, 672 of patients (81.3%) were stone-free after the initial treatment. According to KDIGO, 110 of patients (13.3%) had AKI during the postoperative period. Univariate analysis showed that stone size (P = .003), previous stone surgery (P = .010), renal malformations (P = .017), high operative time (P = < .001), high preoperative creatinine value (P = .036), intraoperative complications (P = .018), and postoperative urinary tract infection (P = .003) had significant influence on the AKI after RIRS. Multivariate analysis excluded previous stone surgery, high preoperative creatinine value, renal malformations, and intraoperative complications from the logistic regression model, whereas other factors maintained their statistically significant effect on AKI, indicating that they were independent predictors.

Conclusions: Stone size, operative time, postoperative urinary tract infection, and diabetes mellitus are significant predictors of AKI. During RIRS, urologists should consider the factors that increase the risk of AKI and evaluate the treatment outcomes based on these factors.

Keywords: Acute kidney injury; Complications; Endourology; Retrograde intrarenal surgery; Urolithiasis.

PubMed Disclaimer

References

    1. Trinchieri A (2008) Epidemiology of urolithiasis: an update. Clin Cases Miner Bone Metab 5:101–106 - PubMed - PMC
    1. Rule AD, Lieske JC, Li X, MeltonKrambeck LJAE, Bergstralh EJ (2014) The ROKS nomogram for predicting a second symptomatic stone episode. J Am Soc Nephrol 25:2878–2886. https://doi.org/10.1681/asn.2013091011 - DOI - PubMed - PMC
    1. Zhe M, Hang Z (2017) Nephrolithiasis as a risk factor of chronic kidney disease: a meta-analysis of cohort studies with 4,770,691 participants. Urolithiasis 45:441–448. https://doi.org/10.1007/s00240-016-0938-x - DOI - PubMed
    1. Geraghty RM, Jones P, Somani BK (2017) Worldwide trends of urinary stone disease treatment over the last two decades: a systematic review. J Endourol 31:547–556. https://doi.org/10.1089/end.2016.0895 - DOI - PubMed
    1. Chugh S, Pietropaolo A, Montanari E, Sarica K, Somani BK (2020) Predictors of urinary infections and urosepsis after ureteroscopy for stone disease: a systematic review from EAU section of urolithiasis (EULIS). Curr Urol Rep 21:16. https://doi.org/10.1007/s11934-020-0969-2 - DOI - PubMed

MeSH terms

Supplementary concepts

LinkOut - more resources