[Determination and its significance of the ratio of urine microalbumin to urine cretinine in patients with nephrolithiasis complicated with renal insufficiency].
OBJECTIVE
To investigate the significance of change of urine microalbumin/urine cretinine (mALB/Ucr) in nephrolithiasis patients with renal dysfunction  (experimental group) before and after percutaneous nephrolithotomy (PCNL).


METHODS
mALB/Ucr value and serum cretinine (Scr) value were analyzed  in 21 nephrolithiasis patients with renal dysfunction before PCNL, and 1, 7, 30 and 90 days after PCNL. Operative time and the number of tract were  recorded and analyzed in the experimental group. The same work was done in 27 nephrolithiasis patients with normal renal function (control group) before  surgery.


RESULTS
The levels of mALB/ Ucr in experimental group patients before PCNL were significantly higher than those in control group (P<0. 001) .  The levels of mALB /Ucr between 7 days after operation and 30 days (P=0.054) or 90 days (P=0.062) after operation were not statistically significant. The  levels of Scr of 30 days after operation in experimental group were lower than those of 7 days after surgery (P<0.001); But they were not statistically  significant compared with those of 90 days after surgery (P=0.106). The mALB/Ucr difference between  before PCNL and 7 days after PCNL (ΔmALB/Ucr)  was positively correlated to the number of operation tract (r=0.486,P=0.030), but it was not correlated to operation time (r=0.323, P=0.129). The ΔmALB/Ucr  was not correlated to Scr difference between before PCNL and 7 days after PCNL (r=0.323, P=0.153). Actually the ΔmALB/Ucr was correlated to Scr  difference between before PCNL and 30 days (r=0.632, P=0.002), or 90 days (r=0.476, P=0.003) after PCNL.


CONCLUSIONS
The damage to kidney filtration  of experimental group was more severe than that of control group. The mALB/Ucr or Scr level of experimental group trends to be stable in 7 or 30 days  after operation. Increasing operation tracts (less than 3 tracts) can help to restore kidney filtration function. A reliable assessment, of a long-term outcome  of the patients' renal function can be reached, by calculating the patients' ΔmALB/Ucr in the experimental group.
Department of Urology, Peking University People's Hospital, Beijing 100044, China.
Liang
L
Chen
Jian-xing
JX
Li
Xiao-bo
XB
Huang
Bo
B
Yang
Jia
J
Wang
Xiao-feng
XF
Wang
D000328:Adult; D000368:Aged; D000419:Albuminuria; D003404:Creatinine / Q000652:urine*; D005260:Female; D006801:Humans; D007669:Kidney Calculi / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D007677:Kidney Function Tests / Q000379:methods; D008297:Male; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous / Q000379:methods*; D051437:Renal Insufficiency / Q000150:complications* / Q000503:physiopathology; D012189:Retrospective Studies; D055815:Young Adult
D003404:Creatinine