Urology Journal

Abstract

Purpose: To assess percutaneous nephrolithotomy (PCNL)-induced kidney tubular damage and the associated factors. Materials and Methods: One hundred and eight patients who have undergone PCNL from May 2007 to October 2007 were recruited in this study. Urinary level of β2-microglobulin (Uβ2MG) was measured on the day before the operation as well as on the 1^st, and 7^th post PCNL days. Percutaneous nephrolithotomy was performed using standard method. Patients' demographic and peri-operative data were collected to evaluate factors influencing renal injury. Results: Median urinary levels of β2-microglobulin on pre-operative, 1^st, and 7^th postoperative days were 0.2 mg/dL (range, 0.1 to 82), 0.4 mg/dL (range, 0.2 to 97), and 0.2 mg/dL (range, 0.2 to 114), respectively. High levels of Uβ2MG (> 2.3 mg/dL) were observed in 10 (9%), 20 (19%), and 10 (9%) patients pre-operatively and on the 1^st, and 7^th postoperative days, respectively. In multivariable analysis, Uβ2MG on the 1^st postoperative day was associated with pre-operative serum creatinine level (P < .001) and diabetes mellitus (P = .05), while Uβ2MG on the 7^th day after the operation was associated with pre-operative serum creatinine level (P = .01), diabetes mellitus (P = .01), and PCNL time (P = .02). Conclusion: Percutaneous nephrolithotomy does not cause kidney tubular injury beyond one week. In patients with pre-operative high serum creatinine concentration, diabetes mellitus, and/or long operation time, the likelihood of the kidney damage is higher than others.