Efficacy and outcome of percutaneous nephrolithotomy in patients with calculus nephropathy.

The aim of this study was to prospectively evaluate the efficacy and outcome of percutaneous nephrolithotomy in patients with nephrolithiasis and chronic renal insufficiency. Between January 2006 and June 2009, 30 patients (20 males and 10 females; mean age 45 years, range 18-65; mean serum creatinine 6.3 ± 1.57 mg%) with calculus nephropathy were treated in our department. In 25 patients with obstructed and infected systems preliminary percutaneous nephrostomy or double J stenting was done. After stabilization and treatment of sepsis, percutaneous nephrolithotomy was done. Eight patients underwent bilateral procedure and 22 underwent unilateral procedure. Twenty-two patients needed a single sitting while eight patients needed two sittings for stone clearance. The renal function was monitored by serial creatinine estimations. Of the 30 patients, 27 patients achieved complete clearance. Renal function was improved in 27 patients. Six patients developed postoperative sepsis. Two patients required angioembolization for uncontrollable bleeding. There was no mortality. Patients with calculus nephropathy can be salvaged using PNL with good improvement in renal function and acceptable morbidity when appropriate preoperative preparation and perioperative care are given.