Nephrolithometry scoring systems in predicting acute kidney injury following percutaneous nephrolithotomy - A prospective observational study.

IF 0.7 Q4 UROLOGY & NEPHROLOGY
Anupam Choudhary, A V B Krishnakanth, K R Surag, Ankit Agarwal, Abhijit Shah, Kasi Viswanath Gali, Padmaraj Hegde
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Abstract

Introduction: Various nephrolithometry scoring systems have been introduced to assess the outcomes of percutaneous nephrolithotomy (PCNL) and postoperative complications. Previous studies have incorporated various variables to determine factors influencing postoperative acute kidney injury (AKI). Using separate scoring systems or nomograms to predict postoperative outcomes and AKI is cumbersome. Our study aims to find if stone scoring systems can be used to predict AKI following a PCNL procedure.

Materials and methods: A prospective observational study was conducted at Kasturba Hospital and Medical College from December 2023 to June 2024. All patients undergoing PCNL were included in the study. Scores were calculated for all patients pre-operatively using various nephrolithometry scoring systems. Patients were divided into two groups based on the presence or absence of AKI following PCNL. The various stone scoring systems were assessed for their ability to predict AKI following PCNL.

Results: Out of the 90 patients in the study, 15 (16.66%) developed AKI, and 75 (83.33%) had no AKI following PCNL. Statistical significance was found in stone size (p < 0.001), stone location (p = 0.011), Staghorn (p < 0.001), Guy's Score (p = 0.001), STONE score (0.002), CROES Score (p = 0.001), Amplatz size (p = 0.012) and energy source (p = 0.01). No statistical significance was found when comparing sex, comorbidities, number of stones, the severity of HN, puncture location and number, intraoperative hypotension, operative time, and duration of hospital stay.

Conclusion: Nephrolithometry scoring systems, in addition to assessing postoperative outcomes such as stone-free rate and complications, can also be used to predict the occurrence of AKI. The use of a limited number of scoring systems to assess all the postoperative outcomes will help simplify and facilitate their use in routine clinical practice.

预测经皮肾镜取石术后急性肾损伤的肾结石评分系统-一项前瞻性观察研究。
导读:各种肾结石测量评分系统被用于评估经皮肾镜取石术(PCNL)的预后和术后并发症。以往的研究纳入了各种变量来确定影响术后急性肾损伤(AKI)的因素。使用单独的评分系统或图来预测术后结果和AKI是很麻烦的。我们的研究旨在发现结石评分系统是否可以用于预测PCNL手术后的AKI。材料和方法:于2023年12月至2024年6月在卡斯图尔巴医院和医学院进行了一项前瞻性观察研究。所有接受PCNL的患者都被纳入研究。术前使用各种肾结石测量评分系统计算所有患者的评分。根据PCNL后AKI的存在与否将患者分为两组。评估各种结石评分系统预测PCNL后AKI的能力。结果:90例患者中,15例(16.66%)发生了AKI, 75例(83.33%)在PCNL术后无AKI。结石大小(p p = 0.011)、Staghorn评分(p p = 0.001)、stone评分(0.002)、CROES评分(p = 0.001)、Amplatz评分(p = 0.012)、能量来源(p = 0.01)均有统计学意义。性别、合并症、结石数量、HN严重程度、穿刺部位及次数、术中低血压、手术时间、住院时间比较,差异无统计学意义。结论:肾结石计分系统除了评估术后无结石率和并发症等预后外,还可用于预测AKI的发生。使用有限数量的评分系统来评估所有术后结果将有助于简化和促进其在常规临床实践中的使用。
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来源期刊
Urologia Journal
Urologia Journal UROLOGY & NEPHROLOGY-
CiteScore
0.60
自引率
12.50%
发文量
66
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