Hussain Manzoor, Hashmi Altaf H, Rizvi Syed Adeebul Hassan
Sindh Institute of Urology and Transplantation (SIUT), Civil Hospital, Karachi, Pakistan.
Urol J. 2013 Spring;10(2):848-55.
To report our recent experience of treating patients with stones associated with renal failure, some of the factors underlying this problem, and few suggestions to avert this tragedy.
From January 2010 to December 2010, a total of 2838 new patients with stone disease were treated at a tertiary care center. The medical files of 278 patients presenting with stone disease and renal failure were reviewed and compared with a cohort of 878 patients with normal renal functions. Their demographic and clinicopathological parameters were noted and analyzed.
Of 2838 patients, 278 (9.7%) presented with acute and chronic renal failure, 40 (1.4%) with unilateral non-functioning kidneys, and 25 (0.8%) with pyonephrosis and perinephric abscess. Management in 278 subjects was divided into initial relief of obstruction by percutaneous nephrolithotomy and double-J stents followed by definitive management in the form of open surgery, percutaneous nephrolithotomy, extracorporeal shockwave lithotripsy, and ureterorenoscopy to make these patients stone-free. Results of treatment showed that 72% of patients either recovered their renal functions or became dialysis-free at the end of the follow-up period.
Complications of renal calculi in the era of modern treatment can be prevented by public education and organizing courses for family physicians as well as opening new stone clinics in the rural areas of the country equipped with modern treatment facilities and strategies for prevention of renal calculi.
报告我们近期治疗伴有肾衰竭的结石患者的经验、该问题的一些潜在因素以及避免这一悲剧的几点建议。
2010年1月至2010年12月，一家三级医疗中心共治疗了2838例新发结石病患者。回顾了278例患有结石病并伴有肾衰竭患者的病历，并与878例肾功能正常的患者队列进行比较。记录并分析了他们的人口统计学和临床病理参数。
在2838例患者中，278例（9.7%）出现急性和慢性肾衰竭，40例（1.4%）出现单侧肾功能丧失，25例（0.8%）出现肾积脓和肾周脓肿。278例患者的治疗分为通过经皮肾镜取石术和双J管置入术初步解除梗阻，随后采用开放手术、经皮肾镜取石术、体外冲击波碎石术和输尿管肾镜检查等确定性治疗方法，以使这些患者无结石。治疗结果显示，72%的患者在随访期结束时恢复了肾功能或不再需要透析。
通过公众教育、为家庭医生组织课程以及在该国农村地区开设配备现代治疗设施和肾结石预防策略的新结石诊所，可以预防现代治疗时代肾结石的并发症。
