Faculty of Medicine, Urology Department, Erzincan Binali Yildirim University, Erzincan, Turkey.
Faculty of Medicine, Biochemistry Department, Erzincan Binali Yildirim University, Erzincan, Turkey.
Urologia. 2023 May;90(2):335-341. doi: 10.1177/03915603221118458. Epub 2022 Sep 5.
Percutaneous nephrolithotomy (PNL) and retrograde intrarenal surgery (RIRS) are common surgical methods in the treatment of kidney stones. Possible effects on kidneys are an important factor in determining the surgical procedure and the surgical method. In our study, kidney injury molecule-1 (KIM-1) and myo-inositol oxygenase (MIOX) were used to compare acute kidney injury in patients that underwent PNL and RIRS.
Eighty patients aged 20-75, who underwent PNL or RIRS in our urology clinic between November 2018 and February 2020 were included in the study. In this prospective study, the demographic characteristics, stone size, operation time, preoperative and postoperative hemoglobin and biochemistry values of the patients were recorded. About 5 cc blood samples taken from the patients before the operation and at the fourth hour after the operation were centrifuged and kept at -80°C, and the KIM-1 and MIOX levels were measured in the biochemistry department.
There was no difference between the groups in terms of demographic data; however, the operation time and length of hospital stay were significantly longer in the PNL group. The mean increase in MIOX was 10.583 ± 9.73 and 7.501 ± 16.46 ng/ml in the PNL and RIRS groups, respectively. Although there was a statistically significant increase in both groups, this increase was greater in the PNL group. A significant increase was observed only in the PNL group in the postoperative period ( = 0.003).
The findings of the study suggest that the PNL procedure causes more damage to the kidneys than RIRS.
经皮肾镜碎石术（PNL）和逆行性肾内手术（RIRS）是治疗肾结石的常见手术方法。对肾脏的可能影响是决定手术程序和手术方法的一个重要因素。在我们的研究中，使用肾损伤分子-1（KIM-1）和肌醇氧化酶（MIOX）来比较接受 PNL 和 RIRS 的患者的急性肾损伤。
2018 年 11 月至 2020 年 2 月期间在我院泌尿科接受 PNL 或 RIRS 的 80 例年龄在 20-75 岁的患者纳入本研究。在这项前瞻性研究中，记录了患者的人口统计学特征、结石大小、手术时间、术前和术后血红蛋白和生化值。从患者术前和术后第 4 小时采集约 5cc 血样，离心后保存在-80°C，在生化科测量 KIM-1 和 MIOX 水平。
两组患者的人口统计学数据无差异；然而，PNL 组的手术时间和住院时间明显更长。PNL 和 RIRS 组 MIOX 的平均增加值分别为 10.583±9.73 和 7.501±16.46ng/ml。虽然两组均有统计学显著增加，但 PNL 组增加更为明显。仅在 PNL 组术后观察到显著增加（=0.003）。
研究结果表明，PNL 程序对肾脏的损伤大于 RIRS。
