Abdominal X-ray, abdominal computed tomography (CT), emission computed tomography and diuresis renography were used to evaluate the solitary kidney patients with renal staghorn calculi for inclusion into this study. The preoperative medical records of the patients were closely followed and their renal functions were followed up in the first and sixth months after PCNL. Because of the retrospective nature of the research, the requirement for informed consent was waived.Ĭlinical data over a 5.5-year-period from March 2014 to June 2019 were recorded from consecutive solitary kidney patients with renal staghorn calculi who underwent PCNL. The study has conformed to the provisions of the Declaration of Helsinki (as revised in 2013). The present study was conducted with the approval and supervised by the ethics committee of West China Hospital. We present this article in accordance with the STROBE reporting checklist (available at ). These risk factors can be used to guide reasonable control in clinical works and to protect renal function after PCNL in solitary kidney patients with staghorn calculi. Taking into account this knowledge, we aim to evaluate the risk factors that deteriorate the renal function in solitary kidney patients with staghorn calculi after PCNL. For patients with renal calculi, renal function can be improved after surgery in most cases, but whether there are some factors deteriorating the renal function of solitary kidney patients with staghorn calculi after PCNL is still unclear. In general, some combined diseases, such as diabetes, hypertension and repeated urinary tract infections (UTI), may affect renal function in the long run by changing the vascular structure and affecting local blood supply, causing local inflammation to change local metabolism ( 5- 7). However, it has not been reported in detail which factors have adverse effects on PNCL in solitary kidney patients with staghorn calculi. A recent study demonstrates that PCNL is safe and effective for solitary kidney patients and can improve renal function at the post-operative sixth month ( 4). As an operation requiring kidney puncturing, however, PCNL unavoidably can damage renal function to certain degree. Normal renal function is more important for solitary kidney patients. Percutaneous nephrolithotomy (PCNL), a commonly-performed minimally invasive procedure, has been recommended as the first-line treatment for staghorn calculi because of the higher stone-free rate (SFR) achieved with minimal morbidity ( 3). Staghorn calculi remain a challenge for urologists, especially in some special situations, such as solitary kidney, ectopic kidney, and horseshoe kidney. Therefore, it is necessary to actively manage stones to avoid adverse consequences. Renal stones may bring about a loss of renal function and increase the risk of papillary renal cell carcinoma ( 2). The incidence of renal stones is around 10–20% ( 1) and is still rising through the changes of living habits and the increasing prevalence of related medical conditions, such as metabolic syndrome, obesity and diabetes mellitus. Urolithiasis is a common disease of the urinary system.
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