Does the metabolic syndrome or its components affect the outcome of percutaneous nephrolithotomy?
OBJECTIVE
Metabolic syndrome is a cluster of cardiovascular disease risk factors. We assessed the impact of these medical disorders on the outcome of percutaneous nephrolithotomy (PCNL).


METHODS
Data from 430 consecutive PCNL procedures were retrospectively reviewed. The presence of serum lipid abnormalities (SLA), hypertension (HT), diabetes (DM), and obesity was investigated. Patients were determined to have the metabolic syndrome according to the definition of the International Diabetes Federation. Success rate, need for auxiliary procedures, and major complication rates of PCNL were analyzed separately for patients with or without DM, SLA, HT, obesity, and the metabolic syndrome, and were compared.


RESULTS
SLA, HT, and DM were observed in 123 (28.6%), 108 (25.1%), and 44 (10.2%) patients, respectively. Body mass index was >30 kg/m2 in 74 (17.2%) patients. Metabolic syndrome was diagnosed in 41 (9.5%) patients. An overall success rate of 96.3% for PCNL was achieved. Success rates were not significantly (P > 0.05) influenced by the presence of SLA, HT, DM, obesity, or the metabolic syndrome. Major complications were encountered in 49 (11.4%) patients and were 2.5 to 2.7 times more common in patients with DM, HT, and the metabolic syndrome. In patients with DM, auxiliary treatment alternatives were necessary in 20.5%, while they were indicated in 10.9% of patients without DM (P = 0.046). Presence of the metabolic syndrome was also associated with an increased necessity for auxiliary treatments after PCNL (P = 0.048).


CONCLUSIONS
Our results indicate that the metabolic syndrome and its components (DM and HT) significantly augment auxiliary treatment and complication rates after PCNL.
Tefekli
Ahmet
A
Department of Urology, Haseki Teaching and Research Hospital, Haseki, Istanbul, Turkey. atefekli@yahoo.com
Kurtoglu
Hilal
H
Tepeler
Kadir
K
Karadag
Mert Ali
MA
Kandirali
Engin
E
Sari
Erhan
E
Baykal
Murat
M
Muslumanoglu
Ahmet Yaser
AY
D000293:Adolescent; D000328:Adult; D000368:Aged; D015992:Body Mass Index; D002648:Child; D048909:Diabetes Complications; D005260:Female; D006801:Humans; D006973:Hypertension / Q000097:blood; D007669:Kidney Calculi / Q000150:complications / Q000601:surgery*; D008055:Lipids / Q000097:blood; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications*; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous / Q000009:adverse effects; D016896:Treatment Outcome
D008055:Lipids