Risk factors and interventions for post-percutaneous nephrolithotomy urinary tract infection in diabetic patients with renal calculi.

Abstract

Objective: To investigate risk factors and interventions for post-percutaneous nephrolithotomy (PCNL) urinary tract infection (UTI) in patients with renal calculi and diabetes mellitus (DM).

Methods: Clinical data of 210 DM patients with renal calculi who underwent PCNL at Hu Zhou Central Hospital between January 2018 and October 2024 were retrospectively analyzed. Patients were divided into infection and non-infection groups based on post-PCNL UTI occurrence. Univariate and multivariate logistic regression analyses was performed to identify risk factors. Negative emotions (Self-Rating Anxiety/Depression Scale [SAS]/[SDS]), pain intensity (Visual Analogue Scale [VAS]), sleep quality (Pittsburgh Sleep Quality Index [PSQI]), and quality of life level (Short-Form 36-Item Health Survey [SF-36]) were also assessed.

Results: Among the 210 patients, 33 (15.71%) developed post-PCNL UTI, with 27 (67.50%) Gram-negative bacterial strains identified. Univariate analysis revealed that age, operation time (OT), number of renal calculi, fasting blood glucose (FBG), and preoperative UTI were significantly associated with post-PCNL UTI. Multivariate analysis identified age ≥60 years (P=0.001), OT ≥90 min (P=0.031), FBG ≥10 mmol/L (P<0.001), and preoperative UTI (P=0.013) as independent risk factors. Patients with UTI exhibited significantly higher SAS, SDS, VAS, and PSQI scores, along with lower SF-36 scores compared to non-infected patients.

Conclusions: Age ≥60 years, OT ≥90 min, FBG ≥10 mmol/L, and preoperative UTI are risk factors for post-PCNL UTI. Patients with these risk factors require enhanced perioperative nursing and targeted preventive measures. Furthermore, tailored interventions should be implemented to address their negative emotions, pain, sleep quality, and quality of life.