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Effects of Plasma Creatinine Levels on Bleeding in Percutaneous Nephrolithotomy

Year 2015, Volume: 40 Issue: 2, 221 - 225, 10.09.2015
https://doi.org/10.17826/cutf.30438

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

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.
  • Schoorl M, Schoorl M, Nubé MJ, Bartels PCM. Coagulation activation, depletion of platelet granules and endothelial integrity in case of uraemia and haemodialysis treatment. BMC Nephrol. 2013;14:72.

Serum Kreatinin Seviyelerinin Perkütan Nefrolitotripside Kanama Üzerine Etkisi

Year 2015, Volume: 40 Issue: 2, 221 - 225, 10.09.2015
https://doi.org/10.17826/cutf.30438

Abstract

Amaç: Perkütan nefrolitotripsi (PNL), ürolojinin son yıllarına damga vurmuş, pek çok merkezde uygulanabilen, morbiditesi ve mortalitesi son derece düşük bir tedavi yöntemi olarak karşımıza çıkmaktadır. Biz bu çalışmamızda, PNL öncesi serum kreatinin değerindeki yüksekliğin post operatif kanama durumuna etkisini araştırmayı amaçladık. Materyal ve Metod: Kliniğimizde PNL uygulanmış olan hastalar arasında üre ve kreatinin değerleri yüksek olan hastalar ayrıldı. Bu hastaların yaşları, taş boyutları, cinsiyetleri, tedavi öncesi hematokrit değerleri ve ek ko-morbiditeleri kaydedilerek hastaların bu değerlerine benzer değerleri olan hastalar ile diğer grup oluşturuldu. Serum kreatinin Araştırma Makalesi / Research Article 221 Şener ve ark. Cukurova Medical Journal değerleri yüksek olanlar Grup 1, normal olanlar ise Grup 2 olarak adlandırıldı. Hastaların beden kitle endeksi, taş boyutları, operasyon öncesi ve sonrası kreatin değeri, operasyon öncesi ve sonrası hematokrit değeri, preoperatif trombosit sayısı, koagülasyon parametreleri (aPTT, INR değerleri), trakt sayısı, operasyon süresi, preoperatif trombosit sayısı, taşsızlık oranları ve eritrosit transfüzyonu olup olmadığı kaydedilerek kıyaslandı. Bulgular: Gruplarda preoperatif kreatinin değerleri sırası ile Grup 1 ve 2 için 2,11 ± 0,44 ve 0,98 ± 0,27 idi. Taş boyutları 1. Grup için 29,41 ± 3,83 mm, 2. Grup için ise 29,49 ± 2,99 idi (p=0,317). Hastaların operasyon öncesi hematokrit değerleri 1 ve 2. Gruplar için sırasıyla 44,88 ± 5,61 ve 47,51 ± 4,61 idi (p=0,381). Bu değerler operasyon sonrası her iki grup için sırası ile 30,27 ± 7,01 ve 37,74 ± 7,11 idi (p=0,044). Sonuç: Çalışmamızda kreatinin değerlerinin PNL sonrası kanama için bir risk faktörü olduğu, serum kreatinin değerlerinin yüksekliği olan hastalarda, olmayanlara oranla hematokrit düşüşünün daha fazla olduğu görülmektedir.

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.
  • Schoorl M, Schoorl M, Nubé MJ, Bartels PCM. Coagulation activation, depletion of platelet granules and endothelial integrity in case of uraemia and haemodialysis treatment. BMC Nephrol. 2013;14:72.
There are 11 citations in total.

Details

Primary Language English
Journal Section Research
Authors

Nevzat Şener This is me

Ufuk Öztürk This is me

Kürşad Zengin This is me

Emine Şener This is me

Okan Baş This is me

Smail Nalbant This is me

Abdurrahim İmamoğlu This is me

Publication Date September 10, 2015
Published in Issue Year 2015 Volume: 40 Issue: 2

Cite

MLA Şener, Nevzat et al. “Effects of Plasma Creatinine Levels on Bleeding in Percutaneous Nephrolithotomy”. Cukurova Medical Journal, vol. 40, no. 2, 2015, pp. 221-5, doi:10.17826/cutf.30438.