Postoperative renal functional changes assessed by 99m Tc-DTPA scintigraphy and predictive factors after miniaturized percutaneous nephrolithotomy and retrograde intrarenal surgery: An observational 1-year follow-up study.

Purpose: We evaluated the comparative effect of miniaturized percutaneous nephrolithotomy (mini-PCNL) and retrograde intrarenal surgery (RIRS) on perioperative kidney function by use of diethylenetriamine penta-acetic acid ( ^99m Tc-DTPA) scintigraphy and identified significant predictors associated with deterioration or amelioration of renal function after surgery.
Materials and Methods: All 70 patients who underwent mini-PCNL or RIRS between 2012 and 2016 were monitored by ^99m Tc-DTPA scintigraphy preoperatively. Patients with abnormal renal function were monitored from 3 to 12 months postoperatively. Logistic regression analyses were conducted to estimate the predictors of aggravated renal dysfunction and improvement.
Results: The difference in preoperative renal function between the contralateral and the operative side was >10% in 57 patients (81.4%). Among those in the group with abnormal renal function, 40 (70.2%), 10 (17.5%), and 7 (12.3%) patients showed stability, deterioration, and improvement in renal function at postoperative year 1, respectively. Functional changes did not differ according to the type of surgery. A high level of serum creatinine preoperatively (p=0.060) and a history of previous stone procedures (p=0.051) showed borderline significance for prediction of deterioration in renal function.
Conclusions: RIRS and mini-PCNL had similar effects and favorable outcomes on renal function during a 1-year follow-up period. High baseline serum creatinine levels and a history of procedures warrant careful attention.
Competing Interests: CONFLICTS OF INTEREST: The authors have nothing to disclose.
(© The Korean Urological Association, 2020.)