Effects of Plasma Creatinine Levels on Bleeding in Percutaneous Nephrolithotomy
Abstract
Purpose: Percutaneous Nephrolithotomy (PNL), has been a breakthrough in urology practice; it can be performed in various centers, with high success rates and low morbidity and mortality rates. In this study, we aimed to investigate the effect of plasma creatinine levels upon the hemorrhage on PNL procedures. Material and Methods: Patients underwent PNL were categorized as having high plasma urea and creatinine levels. Patient age, stone size, gender, hematocrit levels and additional co-morbidities were recorded and a matching group was designed using same variables. Group 1 consisted of patients with high creatinine levels and Group 2 consisted of normal creatinine levels. Body mass index, stone size, hematocrit levels, plasma creatinine levels before and after the operation, coagulation parameter (aPTT, INR), number of access tracts, operative time, preoperative platelet number, stone free rates and transfusion rates were recorded and compared. Results: Mean plasma creatinine levels were 2,11 ± 0,44 and 0,98 ± 0,27 for Groups 1 and 2, respectively. For Groups 1 and 2, stone sizes were 29,41 ± 3,83 mm, and 29,49 ± 2,99 (p=0,317). Mean peroperative hematocrit levels were 44,88 ± 5,61 and 47,51 ± 4,61 (p=0,381) for Groups 1 and 2, respectively. Those levels were 30,27 ± 7,01 and 37,74 ± 7,11 (p=0,044) for Groups 1 and 2 post operatively. Conclusion: In conclusion, having high levels of plasma creatinine preoperatively for PNL was seen to be a risk factor for hemorrhage. If a patient has high creatinine levels preoperatively, he/she may be more prone to bleeding after PNL
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References
- Armitage JN, Irving SO, Burgess N a. Percutaneous Nephrolithotomy in the United Kingdom: Results of a Prospective Data Registry. Eur. Urol. 2012:1–6.
- Knoll T, Wendt-Nordahl G, Alken P. Clinical value of percutaneous nephrolithotomy. Urol. Aug. 2005;44:299–306; quiz 307–308.
- Turk C, Knoll T, Petrik A, Sarika K, Straub M. Guidelines on urolithiasis. Eur. Assoc. Urol. (Internet) 2013; http://www.ncbi.nlm.nih.gov/pubmed/19585096
- Kessaris DN, Bellman GC, Pardalidis NP, Smith AG. Management of hemorrhage after percutaneous renal surgery. J. Urol. 1995;153:604–8.
- Lee WJ, Smith AD, Cubelli V, Badlani GH, Lewin B, Vernace F, et al. Complications of percutaneous nephrolithotomy. AJR Am. J. Roentgenol. 1987;148:177–80.
- Rastinehad AR, Andonian S, Smith AD, Siegel DN. Management of hemorrhagic complications associated with percutaneous nephrolithotomy. J. Endourol. Endourol. Soc. 2009;23:1763–7.
- Clayman RV, Surya V, Hunter D, Castaneda-Zuniga WR, Miller RP, Coleman C, et al. Renal vascular complications associated with the percutaneous removal of renal calculi. 1984.
- Turna B, Nazli O, Demiryoguran S, Mammadov R, Cal C. Percutaneous nephrolithotomy: variables that influence hemorrhage. Urology 2007;69:603–7.
- Akman T, Binbay M, Sari E, Yuruk E, Tepeler A, Akcay M, et al. Factors affecting bleeding during percutaneous nephrolithotomy: single surgeon 12. Zeck J, Schallheim J, Lew SQ, DePalma L. Whole experience. J. Endourol. Endourol. Soc. 2011;25:327–33.
- Kurtulus F, Fazlioglu A, Tandogdu Z, Karaca S, Salman Y, Cek M. Analysis of factors related with bleeding in percutaneous nephrolithotomy using balloon dilatation. Can. J. Urol. 2010;17:5483–9.
