Minimally Invasive Urological Surgery in Patients with Renoureteral Lithiasis and Previous Kidney Function Damage
Keywords:
chronic kidney disease, kidney disease, urolithialis, ureteroscopy, percutaneous nephrolithotomy.Abstract
Introduction: Surgical treatment for lithiasis in patients with renal damage by minimally invasive surgery has been shown to positively influence post-operative renal function.
Objective: To evaluate the state of renal function after minimally invasive surgery in patients with renoureteral lithiasis and previous damage to renal function.
Methods: Explanatory, longitudinal study in 302 patients with functional kidney damage operated by minimally invasive surgery between 2018 and 2019 at “Dr. Abelardo Buch López” Institute of Nephrology. The variables studied were: age, gender, comorbidities, cause of pre-operative kidney damage, estimated pre-operative glomerular filtration rate, classification of pre- and post-operative kidney damage, pre-operative diagnosis, minimally invasive surgical technique performed, complications and their severity, estimated post-operative glomerular filtration rate, and post-operative renal damage progression. Absolute frequencies and percentage distribution were calculated using the Student's test and chi-squared. For the multivariate analysis, the Wald test was used.
Results: 92.7% of patients had comorbidities. Multicausal kidney damage was the most frequent (35.4%). Ureteral lithiasis was the predominant diagnosis (35.8%), correspondingly ureteroscopy predominated (41.7%). Complications occurred in 28.1% of cases. After surgery, kidney function was restored by 34.1% and improved by 41.4%. Multicausal, obstructive and hypertensive nephropathy and pre-operative glomerular filtration rate were associated with post-operative renal damage (p ≤ 0.05), but after multivariate analysis none were significantly associated (p > 0.05).
Conclusions: Minimally invasive urological surgery is feasible with a satisfactory impact on the recovery of renal function in patients with previous renal damage.
Downloads
Download data is not yet available.
References
1. Borrego Moreno Y, Serra Valdés MA, Cordero López G. Detección de enfermedad renal crónica oculta en pacientes hospitalizados en un servicio de Medicina Interna. Rev Acta Médica. 2020[acceso 15/03/2023];21(1):1-17. Disponible en: https://www.medigraphic.com/pdfs/actamedica/acm-2020/acm201d.pdf
2. Yang CW, Harris DC, Luyckx VA, Nangaku M, Hou FF, Garcia GG, et al. Global case studies for chronic kidney disease / end-stage kidney disease care. Kidney Int Suppl. 2020[acceso 15/03/2023];10(1):e24-e48. Disponible en: https://www.sciencedirect.com/science/article/abs/pii/S2157171619300243
3. Kovesdy CP. Epidemiology of chronic kidney disease: an update 2022. Kidney Int Suppl. 2022[acceso 15/03/2023];12(1):7-11. Disponible en: https://www.sciencedirect.com/science/article/pii/S2157171621000666
4. Luyckx VA, Cherney DZ, Bello AK. Preventing CKD in developed countries. Kidney Int Rep. 2020[acceso 15/03/2023];5(3):263-77. Disponible en: https://www.sciencedirect.com/science/article/pii/S2468024919315864
5. Lysak N, Hashemighouchani H, Davoudi A, Pourafshar N, Loftus T, Ruppert M, et al. Cardiovascular death and progression to end‐stage renal disease after major surgery in elderly patients. BJS open. 2020 [acceso 15/03/2023];4(1):145-56. Disponible en: https://bjssjournals.onlinelibrary.wiley.com/doi/pdf/10.1002/bjs5.50232
6. D’Costa M, Savcic-Kos R, Huang J, Rule AD, Murali N. Urological procedures in urolithiasis and their association with chronic kidney disease. Clin Med Res. 2016 [acceso 15/03/2023];14(2):75-82. Disponible en: http://www.clinmedres.org/content/14/2/75.full.pdf+html
7. Jung JH, Yoo S, Park J, Cho MC, Son H, Jeong H, et al. Postoperative renal functional changes assessed by 99mTc-DTPA scintigraphy and predictive factors after miniaturized percutaneous nephrolithotomy and retrograde intrarenal surgery: An observational 1-year follow-up study. Investig Clin Urol. 2020 [acceso 15/03/2023];61(1):59-66. Disponible en: https://synapse.koreamed.org/articles/1140275
8. Medina Escobedo M, Sánchez Pozos K, Gutiérrez Solis AL, Avila Nava A, González Rocha L, Lugo R. Recurrence of Nephrolithiasis and Surgical.Events Are Associated with Chronic Kidney Disease in Adult Patients. Medicina. 2022 [acceso 15/03/2023];58(3):420. Disponible en: https://www.mdpi.com/1648-9144/58/3/420
9. Scotland KB, Armas-Phan M, Dominique G, Bayne D. Social Determinants of Kidney Stone Disease: The Impact of Race, Income and Access on Urolithiasis Treatment and Outcomes. Urology. 2022 [acceso 15/03/2023];163:190-5.Disponible en: https://www.sciencedirect.com/science/article/pii/S0090429521008347
10. Tanemoto F, Mimura I. Therapies Targeting Epigenetic Alterations in Acute Kidney Injury-to-Chronic Kidney Disease Transition. Pharmaceuticals. 2022 [acceso 15/03/2023];15(2):123. Disponible en: https://www.mdpi.com/1424-8247/15/2/123
11. Szavay PO. Applications of laparoscopic surgery in pediatric
urology. Front Pediatr. 2019[acceso 15/03/2023];7:29. Disponible en: https://www.frontiersin.org/articles/10.3389/fped.2019.00029/full
12. Cedeño Cedeño YM, Pazmiño Chancay MJ, D’Ilio Gil HDV, Aguirre Tello AE. Cirugía robótica, la transición de la cirugía en la actualidad. RECIAMUC. 2022 [acceso 06/05/2023];6(2):269-7. Disponible en: https://www.reciamuc.com/index.php/RECIAMUC/article/view/862/1259
13. Territo A, Bajeot AS, Mesnard B, Campi R, Pecoraro A, Hevia V, et al. Open versus robotic-assisted kidney transplantation: A systematic review by the European Association of Urology (EAU)–Young Academic Urologists (YAU) Kidney Transplant Working Group. Actas Urol Esp (English Edition). 2023 [acceso 15/03/2023]. Disponible en: https://www.sciencedirect.com/science/article/abs/pii/S2173578623000392
14. González León T, Suárez Marcillán ME, Cuza Herrera Y, Tegegne A, de la Paz Pérez Y, Rodríguez-Ojea L. Cirugía laparoscópica para el tratamiento de la litiasis del uréter lumbar. Rev Cubana Urol. 2016 [acceso 15/03/2023];5(1):17-29. Disponible en: https://revurologia.sld.cu/index.php/rcu/article/view/244
15. Fuster Such DC, Martinez Cutillas DMJ, Borrás Fernández DM, López Martín DJB, Iglesias González DMDM, Melgares De Aguilar DD. Uropatía obstructiva y su tratamiento percutáneo: no todo son litiasis. Seram. 2022 [acceso 15/03/2023];1(1). Disponible en: https://www.piper.espacio-seram.com/index.php/seram/article/view/9579/8045
16. Dejban P, Wilson EM, Jayachandran M, Herrera Hernandez LP, Haskic Z, Wellik LE, et al. Inflammatory Cells in Nephrectomy Tissue from Patients without and with a History of Urinary Stone Disease. Clin J Am Soc Nephrol. 2022 [acceso 06/05/2023];17(3). Disponible en: https://journals.lww.com/cjasn/Fulltext/2022/03000/Inflammatory_Cells_in_Nephrectomy_Tissue_from.12.aspx
17. Golomb D, Dave S, Berto FG, McClure JA, Welk B, Wang P, et al. A population-based, retrospective cohort study analyzing contemporary trends in the surgical management of urinary stone disease in adults. Can Urol Assoc J. 2022 [acceso 06/05/2023];16(4):112-8. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9054339/
18. Fadhil YS. A study on renal stones incidence with regard to age, gender and chemical composition of stones in Western Iraq. Int J Health Sci. 2022 [acceso 06/05/2023];6(S1):9814-8. Disponible en: https://media.neliti.com/media/publications/430413-a-study-on-renal-stones-incidence-with-r-7cde1434.pdf
19. Stamatelou K, Goldfarb DS. Epidemiology of Kidney Stones. Healthcare. 2023[acceso 06/05/2023];11(3):424. Disponible en: https://www.mdpi.com/2227-9032/11/3/424
20. Chewcharat A, Thongprayoon C, Vaughan LE, Mehta RA, Schulte PJ, O’Connor HM, et al. Dietary Risk Factors for Incident and Recurrent Symptomatic Kidney Stones. Mayo Clin Proc. 2022 [acceso 06/05/2023];97(8):1437-48. Disponible en: https://www.sciencedirect.com/science/article/abs/pii/S0025619622002592
21. Rodríguez Pastoriza R, Roque Morgado M, Gonzalez León T. Factores de riesgo para padecer litiasis urinaria en una población cubana. Rev Cubana Urol. 2022 [acceso 06/05/2023];11(1):25-35. Disponible en: https://revurologia.sld.cu/index.php/rcu/article/view/761
22. Castillo Rodríguez M, Gonzalez León T, Castillo López R, Gutiérrez Rojas A, Borreros Barrientos L, Ramírez Mena A. Comportamiento de la litiasis residual en pacientes tratados con nefrolitotomía percutánea por cálculo renal coraliforme. Rev Cubana Urol. 2022 [acceso 06/05/2023];11(1):49-61. Disponible en: https://revurologia.sld.cu/index.php/rcu/article/view/779
23. Lee EH, Kim SH, Shin JH, Park SB, Chi BH, Hwang JH. Effects on renal outcome of concomitant acute pyelonephritis, acute kidney injury and obstruction duration in obstructive uropathy by urolithiasis: a retrospective cohort study. BMJ open. 2019[acceso 06/05/2023];9(11):e030438. Disponible en: https://bmjopen.bmj.com/content/bmjopen/9/11/e030438.full.pdf
24. Rassweiler J, Rassweiler MC, Klein J. New technology in ureteroscopy and percutaneous nephrolithotomy. Curr Opin Urol. 2016;26(1):95-106. DOI: 10.1097/MOU.0000000000000240
25. Yang B, Ning H, Liu Z, Zhang Y, Yu C, Zhang X, et al. Safety and efficacy of flexible ureteroscopy in combination with holmium laser lithotripsy for the treatment of bilateral upper urinary tract calculi. Urol Int. 2017;98(4): 418-24. DOI:10.1159/000464141
26. Choo MS, Ryu KH, Park J, Cho MC, Son H, Jeong H, et al. A prospective, observational study to investigate change of separate renal function in patients who underwent minimally invasive renal stone surgery according to the preoperative differential renal function. Eur Urol Suppl. 2017;16(3):e591-e592. DOI:10.1016/s1569-9056(17)30403-7
27. Reeves T, Pietropaolo A, Gadzhiev N, Seitz C, Somani BK. Role of endourological procedures (PCNL and URS) on renal function: a systematic review. Curr Urol Rep. 2020 [acceso 06/05/2023];21(5):1-11. Disponible en: https://link.springer.com/article/10.1007/s11934-020-00973-4
28. Yuruk E, Binbay M, Ozgor F, Erbin A, Berberoglu Y, Muslumanoglu AY. Flexible ureterorenoscopy is safe and efficient for the treatment of kidney stones in patients with chronic kidney disease. Urology. 2014[acceso 06/05/2023];84(6):1279-84. Disponible en: https://www.sciencedirect.com/science/article/abs/pii/S0090429514008085
29. Schmid M, Dalela D, Tahbaz R, Langetepe J, Randazzo M, Dahlem R, et al. Novel biomarkers of acute kidney injury: Evaluation and evidence in urologic surgery. World J Nephrol. 2015 [acceso 06/05/2023];4(2):160. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4419126/
30. Boyer N, Eldridge J, Prowle JR, Forni LG. Postoperative Acute Kidney Injury. Clin J Am Soc Nephrol. 2022 [acceso 06/05/2023];17(10). Disponible en: https://journals.lww.com/cjasn/Fulltext/2022/10000/Postoperative_Acute_Kidney_Injury.16.aspx
2. Yang CW, Harris DC, Luyckx VA, Nangaku M, Hou FF, Garcia GG, et al. Global case studies for chronic kidney disease / end-stage kidney disease care. Kidney Int Suppl. 2020[acceso 15/03/2023];10(1):e24-e48. Disponible en: https://www.sciencedirect.com/science/article/abs/pii/S2157171619300243
3. Kovesdy CP. Epidemiology of chronic kidney disease: an update 2022. Kidney Int Suppl. 2022[acceso 15/03/2023];12(1):7-11. Disponible en: https://www.sciencedirect.com/science/article/pii/S2157171621000666
4. Luyckx VA, Cherney DZ, Bello AK. Preventing CKD in developed countries. Kidney Int Rep. 2020[acceso 15/03/2023];5(3):263-77. Disponible en: https://www.sciencedirect.com/science/article/pii/S2468024919315864
5. Lysak N, Hashemighouchani H, Davoudi A, Pourafshar N, Loftus T, Ruppert M, et al. Cardiovascular death and progression to end‐stage renal disease after major surgery in elderly patients. BJS open. 2020 [acceso 15/03/2023];4(1):145-56. Disponible en: https://bjssjournals.onlinelibrary.wiley.com/doi/pdf/10.1002/bjs5.50232
6. D’Costa M, Savcic-Kos R, Huang J, Rule AD, Murali N. Urological procedures in urolithiasis and their association with chronic kidney disease. Clin Med Res. 2016 [acceso 15/03/2023];14(2):75-82. Disponible en: http://www.clinmedres.org/content/14/2/75.full.pdf+html
7. Jung JH, Yoo S, Park J, Cho MC, Son H, Jeong H, et al. Postoperative renal functional changes assessed by 99mTc-DTPA scintigraphy and predictive factors after miniaturized percutaneous nephrolithotomy and retrograde intrarenal surgery: An observational 1-year follow-up study. Investig Clin Urol. 2020 [acceso 15/03/2023];61(1):59-66. Disponible en: https://synapse.koreamed.org/articles/1140275
8. Medina Escobedo M, Sánchez Pozos K, Gutiérrez Solis AL, Avila Nava A, González Rocha L, Lugo R. Recurrence of Nephrolithiasis and Surgical.Events Are Associated with Chronic Kidney Disease in Adult Patients. Medicina. 2022 [acceso 15/03/2023];58(3):420. Disponible en: https://www.mdpi.com/1648-9144/58/3/420
9. Scotland KB, Armas-Phan M, Dominique G, Bayne D. Social Determinants of Kidney Stone Disease: The Impact of Race, Income and Access on Urolithiasis Treatment and Outcomes. Urology. 2022 [acceso 15/03/2023];163:190-5.Disponible en: https://www.sciencedirect.com/science/article/pii/S0090429521008347
10. Tanemoto F, Mimura I. Therapies Targeting Epigenetic Alterations in Acute Kidney Injury-to-Chronic Kidney Disease Transition. Pharmaceuticals. 2022 [acceso 15/03/2023];15(2):123. Disponible en: https://www.mdpi.com/1424-8247/15/2/123
11. Szavay PO. Applications of laparoscopic surgery in pediatric
urology. Front Pediatr. 2019[acceso 15/03/2023];7:29. Disponible en: https://www.frontiersin.org/articles/10.3389/fped.2019.00029/full
12. Cedeño Cedeño YM, Pazmiño Chancay MJ, D’Ilio Gil HDV, Aguirre Tello AE. Cirugía robótica, la transición de la cirugía en la actualidad. RECIAMUC. 2022 [acceso 06/05/2023];6(2):269-7. Disponible en: https://www.reciamuc.com/index.php/RECIAMUC/article/view/862/1259
13. Territo A, Bajeot AS, Mesnard B, Campi R, Pecoraro A, Hevia V, et al. Open versus robotic-assisted kidney transplantation: A systematic review by the European Association of Urology (EAU)–Young Academic Urologists (YAU) Kidney Transplant Working Group. Actas Urol Esp (English Edition). 2023 [acceso 15/03/2023]. Disponible en: https://www.sciencedirect.com/science/article/abs/pii/S2173578623000392
14. González León T, Suárez Marcillán ME, Cuza Herrera Y, Tegegne A, de la Paz Pérez Y, Rodríguez-Ojea L. Cirugía laparoscópica para el tratamiento de la litiasis del uréter lumbar. Rev Cubana Urol. 2016 [acceso 15/03/2023];5(1):17-29. Disponible en: https://revurologia.sld.cu/index.php/rcu/article/view/244
15. Fuster Such DC, Martinez Cutillas DMJ, Borrás Fernández DM, López Martín DJB, Iglesias González DMDM, Melgares De Aguilar DD. Uropatía obstructiva y su tratamiento percutáneo: no todo son litiasis. Seram. 2022 [acceso 15/03/2023];1(1). Disponible en: https://www.piper.espacio-seram.com/index.php/seram/article/view/9579/8045
16. Dejban P, Wilson EM, Jayachandran M, Herrera Hernandez LP, Haskic Z, Wellik LE, et al. Inflammatory Cells in Nephrectomy Tissue from Patients without and with a History of Urinary Stone Disease. Clin J Am Soc Nephrol. 2022 [acceso 06/05/2023];17(3). Disponible en: https://journals.lww.com/cjasn/Fulltext/2022/03000/Inflammatory_Cells_in_Nephrectomy_Tissue_from.12.aspx
17. Golomb D, Dave S, Berto FG, McClure JA, Welk B, Wang P, et al. A population-based, retrospective cohort study analyzing contemporary trends in the surgical management of urinary stone disease in adults. Can Urol Assoc J. 2022 [acceso 06/05/2023];16(4):112-8. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9054339/
18. Fadhil YS. A study on renal stones incidence with regard to age, gender and chemical composition of stones in Western Iraq. Int J Health Sci. 2022 [acceso 06/05/2023];6(S1):9814-8. Disponible en: https://media.neliti.com/media/publications/430413-a-study-on-renal-stones-incidence-with-r-7cde1434.pdf
19. Stamatelou K, Goldfarb DS. Epidemiology of Kidney Stones. Healthcare. 2023[acceso 06/05/2023];11(3):424. Disponible en: https://www.mdpi.com/2227-9032/11/3/424
20. Chewcharat A, Thongprayoon C, Vaughan LE, Mehta RA, Schulte PJ, O’Connor HM, et al. Dietary Risk Factors for Incident and Recurrent Symptomatic Kidney Stones. Mayo Clin Proc. 2022 [acceso 06/05/2023];97(8):1437-48. Disponible en: https://www.sciencedirect.com/science/article/abs/pii/S0025619622002592
21. Rodríguez Pastoriza R, Roque Morgado M, Gonzalez León T. Factores de riesgo para padecer litiasis urinaria en una población cubana. Rev Cubana Urol. 2022 [acceso 06/05/2023];11(1):25-35. Disponible en: https://revurologia.sld.cu/index.php/rcu/article/view/761
22. Castillo Rodríguez M, Gonzalez León T, Castillo López R, Gutiérrez Rojas A, Borreros Barrientos L, Ramírez Mena A. Comportamiento de la litiasis residual en pacientes tratados con nefrolitotomía percutánea por cálculo renal coraliforme. Rev Cubana Urol. 2022 [acceso 06/05/2023];11(1):49-61. Disponible en: https://revurologia.sld.cu/index.php/rcu/article/view/779
23. Lee EH, Kim SH, Shin JH, Park SB, Chi BH, Hwang JH. Effects on renal outcome of concomitant acute pyelonephritis, acute kidney injury and obstruction duration in obstructive uropathy by urolithiasis: a retrospective cohort study. BMJ open. 2019[acceso 06/05/2023];9(11):e030438. Disponible en: https://bmjopen.bmj.com/content/bmjopen/9/11/e030438.full.pdf
24. Rassweiler J, Rassweiler MC, Klein J. New technology in ureteroscopy and percutaneous nephrolithotomy. Curr Opin Urol. 2016;26(1):95-106. DOI: 10.1097/MOU.0000000000000240
25. Yang B, Ning H, Liu Z, Zhang Y, Yu C, Zhang X, et al. Safety and efficacy of flexible ureteroscopy in combination with holmium laser lithotripsy for the treatment of bilateral upper urinary tract calculi. Urol Int. 2017;98(4): 418-24. DOI:10.1159/000464141
26. Choo MS, Ryu KH, Park J, Cho MC, Son H, Jeong H, et al. A prospective, observational study to investigate change of separate renal function in patients who underwent minimally invasive renal stone surgery according to the preoperative differential renal function. Eur Urol Suppl. 2017;16(3):e591-e592. DOI:10.1016/s1569-9056(17)30403-7
27. Reeves T, Pietropaolo A, Gadzhiev N, Seitz C, Somani BK. Role of endourological procedures (PCNL and URS) on renal function: a systematic review. Curr Urol Rep. 2020 [acceso 06/05/2023];21(5):1-11. Disponible en: https://link.springer.com/article/10.1007/s11934-020-00973-4
28. Yuruk E, Binbay M, Ozgor F, Erbin A, Berberoglu Y, Muslumanoglu AY. Flexible ureterorenoscopy is safe and efficient for the treatment of kidney stones in patients with chronic kidney disease. Urology. 2014[acceso 06/05/2023];84(6):1279-84. Disponible en: https://www.sciencedirect.com/science/article/abs/pii/S0090429514008085
29. Schmid M, Dalela D, Tahbaz R, Langetepe J, Randazzo M, Dahlem R, et al. Novel biomarkers of acute kidney injury: Evaluation and evidence in urologic surgery. World J Nephrol. 2015 [acceso 06/05/2023];4(2):160. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4419126/
30. Boyer N, Eldridge J, Prowle JR, Forni LG. Postoperative Acute Kidney Injury. Clin J Am Soc Nephrol. 2022 [acceso 06/05/2023];17(10). Disponible en: https://journals.lww.com/cjasn/Fulltext/2022/10000/Postoperative_Acute_Kidney_Injury.16.aspx
Downloads
Published
2023-11-05
How to Cite
1.
Fiel IR, León TG, Tamaki RS, Gómez O de la C, Arencibia RR, Roig RJ. Minimally Invasive Urological Surgery in Patients with Renoureteral Lithiasis and Previous Kidney Function Damage. Rev. Cubana Urol. [Internet]. 2023 Nov. 5 [cited 2025 Apr. 3];12(3). Available from: https://revurologia.sld.cu/index.php/rcu/article/view/1022
Issue
Section
Endourología y laparoscopia
License
Aquellos autores/as que tengan publicaciones con esta revista, aceptan los términos siguientes:
- Los autores/as conservarán sus derechos de autor y garantizarán a la revista el derecho de primera publicación de su obra, el cual estará simultáneamente sujeto a la Licencia de Creative Commons Reconocimiento-NoComercial 4.0 Internacional que permite a terceros compartir la obra siempre que se indique su autor y su primera publicación esta revista.
- Los autores/as podrán adoptar otros acuerdos de licencia no exclusiva de distribución de la versión de la obra publicada (p. ej.: depositarla en un archivo telemático institucional o publicarla en un volumen monográfico) siempre que se indique la publicación inicial en esta revista.
- Se permite y recomienda a los autores/as difundir su obra a través de Internet (p. ej.: en archivos telemáticos institucionales o en su página web) antes y durante el proceso de envío, lo cual puede producir intercambios interesantes y aumentar las citas de la obra publicada. (Véase El efecto del acceso abierto).
