Efficacy and safety of diuretic infusion in saline for percutaneous nephrostomy in non-dilated renal collecting systems: A single-center experience.

Abstract

Objective: In this retrospective study, we aimed to investigate the etiology, success, and complication rate of percutaneous nephrostomy (PCN) in patients with non-dilated renal collecting system (NCT) using saline and diuretic agents.

Methods: PCN was performed on 62 kidneys from 35 patients with NCT. Prior to the procedure, a combination of saline and furosemide infusion was administered. Several parameters were evaluated, including pre- and post-procedure levels of creatinine and blood urea nitrogen, fluoroscopy time, total air kerma (TAK), dose area product (DAP), puncture number, success rate, and complication rate.

Results: Fistula was the most common etiology and was detected in 29 out of 62 kidneys. The other most common cause was ureteral injury, detected in 21 out of 62 kidneys. The success rate of our procedures was 96.7%, and the rate of minor complications was 1.7%. Transient macroscopic hematuria was one of the minor complications observed in one patient. No major complications were observed. During each procedure, the average number of needle passes was 1.44±0.5 (range: 1-3). The average duration of the complete procedure was 13.17±6.46 minutes (range: 8-31 minutes). The mean fluoroscopy time was 2.37 minutes (range: 0.8-11.6 minutes). In terms of radiation exposure, the mean DAP was 166.94±148.5 μGy•m² (range: 3.93-666.59 μGy•m²) with a median of 127.04 μGy•m², and the cumulative dose (TAK) was 72.43 mGy (range: 12-342 mGy) with a median of 42.05 mGy, respectively.

Conclusion: Diuretic infusion in saline is a safe and beneficial method for PCN in NCT. With its low complication rate and high success rate, PCN provides rapid treatment for various etiologies with the potential to address conditions such as fistula, ureteral injury, and urosepsis in the collecting system, which may otherwise have devastating consequences.