Plenary: Prime Time, Saturday, Afternoon Session
Laura Bukavina, MD
MD MPH
Case Western/University Hospitals Cleveland Medical Center
Presentation Authors: Michael Wang BS, Laura Bukavina MD MPH*, Cleveland, OH, Kirtishri Mishra MD, Cleveland , OH, Amr Mahran MD MS, Anna Quian BS, Christopher Kondray MD, Anand Patel MD, Donald Bodner MD, Lee Ponsky MD, Ehud Gnessin MD, Cleveland, OH
Introduction: Parenchymal damage and renal function impairment following percutaneous nephrolithotomy (PCNL) is of great concern, despite its efficacy in treating large caliceal kidney stones. This study aims to evaluate postoperative changes in renal volume after PCNL.
Methods: We retrospectively analyzed baseline and post PCNL CT images from 25 eligible patients from a single tertiary care center. All CT imaging was reviewed using 3D planimetry software (3D Splicer ®, Version 4.0). Segmentation was utilized to obtain total kidney volume (TKV), total kidney surface area, total stone surface area, and total stone volume. Wilcoxon signed rank test was used for pair analysis, and univariate and multivariable analysis were performed to examine the relationships between clinical and planimetry data and renal volume loss.
Results: The median age of the cohort was 62 yo, with the majority of the patients having had a previous PCNL (52.0%). The median TKV (g) pre- and post-PCNL were 225.25 and 178.09 respectively (p=0.001), with average volume loss of 21%. While there was a statistically significant kidney volume loss in our cohort, there was no difference between pre /post-operative serum creatinine 0.93 and 0.94 (p=0.696) respectively. Multivariable analysis showed a higher TKV loss with a larger kidney stone surface area (OR: 1.002, CI 1-1.003, p=0.035), while younger age was found to be protective (OR: 0.791, CI 0.587-0.925 p=0.028).
Conclusions: Our study consistently revealed a decrease in TKV following PCNL. Furthermore, among patients with larger stone surface areas, there were an increase in the loss of TKV after the procedure.
Source of Funding: none
