title: Improvement in serum creatinine following definite treatment of urolithiasis in patients with concurrent renal insufficiency.
abstract: OBJECTIVE
  To assess whether definitive treatment of urolithiasis following relief of obstruction in patients with renal insufficiency results in further improvement in renal function as determined by serum creatinine.
  
  
  METHODS
  In a review of 500 patients with urolithiasis, we identified 43 (12%) patients with serum creatinine level of > or =176 micromol/l at the time of presentation. Location and complexity of calculi, type of procedure required to render the patients stone free and effects of surgical intervention (following relief of obstruction) on renal function were evaluated.
  
  
  RESULTS
  Mean serum creatinine at presentation was 555 micromol/l and after relief of obstruction was 361 micromol/l. Mean serum creatinine level after surgical intervention dropped to 193 micromol/l (p < 0.001). Complete or partial staghorn calculi were seen in 40% of patients. Two-thirds of patients required more than one procedure for complete stone clearance.
  
  
  CONCLUSIONS
  Renal calculi and concurrent mild to moderate renal insufficiency warrants aggressive treatments. Patients demonstrate significant improvement in renal function independent of relief of obstruction.
authors.affiliation: Section of Urology, Department of Surgery, The Aga Khan University, Stadium Road, Karachi, Pakistan.
authors.forename: J P
authors.initials: JP
authors.lastname: Paryani
authors.forename: M H
authors.initials: MH
authors.lastname: Ather
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003404:Creatinine / Q000097:blood*; D006801:Humans; D007668:Kidney / Q000503:physiopathology*; D007669:Kidney Calculi / Q000150:complications / Q000628:therapy; D008096:Lithotripsy; D008875:Middle Aged; D051437:Renal Insufficiency / Q000150:complications* / Q000503:physiopathology; D014545:Urinary Calculi / Q000628:therapy*
chemical_list: D003404:Creatinine