The evaluation of renal parenchymal scarring using static renal scintigraphy after percutaneous nephrolithotomy operations

Abstract

Objective: To analyze whether operative techniques and other variables related to patient and renal stone characteristics affect potential renal parenchymal damage.

Materials and Methods: The study population comprised 64 patients who underwent percutaneous nephrolithotomy operations (PCNL). Data of the operated renal units, renal stone burden, route and number of entries, dilation techniques, duration of surgery, preoperative and postoperative glomerular filtration rate (GFR)
and relative dimercaptosuccinic acid (DMSA) uptakes, as well as the changes in
hemoglobin values, were recorded and analyzed for all patients.

Results: The mean age of the patients was 44 years. In 11 (17.1%) cases, renal cortical defects in the 3rd month were detected on DMSA scintigraphy. When the patients with and without renal cortical defect were compared regarding their preoperative and postoperative GFR values, no statistically significant difference was noticed between the groups (P > 0.05). Similarly, when postoperative relative DMSA uptakes were compared with preoperative relative DMSA uptakes of the same kidneys, no statistical significance was seen. When preoperative relative DMSA uptake values between groups with and without renal scarring were compared, no statistically significant difference was observed (P > 0.05).

Conclusion: We did not observe any significant difference in scintigraphic parameters and GFR values. Hence, in the current trial, significant loss in renal function after PCNL operations was not observed. Thus, PCNL operations should be regarded as safe, but still, the risk of loss of kidney function should always be considered.

Keywords: Percutaneous nephrolithotomy, renal scar, renal scintigraphy, renal
stone