title: Tranexamic acid reduces blood loss during percutaneous nephrolithotomy: a prospective randomized controlled study.
abstract: OBJECTIVE
  Bleeding is a significant morbidity associated with percutaneous nephrolithotomy. This study was conducted to evaluate the safety and efficacy of the antifibrinolytic agent tranexamic acid in reducing blood loss in patients undergoing percutaneous nephrolithotomy.
  
  
  METHODS
  A total of 200 patients undergoing percutaneous nephrolithotomy were randomized into 2 equal groups. Patients in the tranexamic acid group received 1 gm tranexamic acid at induction followed by 3 oral doses of 500 mg during 24 hours, while those in the control group did not receive tranexamic acid. The patient demographics and clinical data of the 2 groups were compared.
  
  
  RESULTS
  Baseline patient demographics were similar in both groups. Mean hemoglobin decrease in the tranexamic acid group was significantly lower than that of the control group (1.39 vs 2.31 gm/dl, p <0.0001). Mean operative time in the tranexamic acid group was significantly lower than that in the control group (48.3 vs 70.8 minutes, p <0.0001). The stone clearance rate was similar in both groups (91% vs 82%, p = 0.06). The blood transfusion rate was lower in the tranexamic acid group (2% vs 11%, p = 0.018), as was the complication rate (33% vs 59%, p <0.0001). Two patients with a solitary functioning kidney in the tranexamic acid group required ureteral stenting to relieve anuria due to clot obstruction.
  
  
  CONCLUSIONS
  The use of tranexamic acid in percutaneous nephrolithotomy is safe, and is associated with reduced blood loss and a lower complication rate.
authors.affiliation: Postgraduate Institute of Medical Education and Research, Chandigarh, India. santoshsp1967jaimatadi@yahoo.co.in
authors.forename: Santosh
authors.initials: S
authors.lastname: Kumar
authors.forename: Muninder Singh
authors.initials: MS
authors.lastname: Randhawa
authors.forename: Raguram
authors.initials: R
authors.lastname: Ganesamoni
authors.forename: Shrawan K
authors.initials: SK
authors.lastname: Singh
mesh_terms: D000328:Adult; D000933:Antifibrinolytic Agents / Q000627:therapeutic use*; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008297:Male; D009403:Nephrostomy, Percutaneous; D011446:Prospective Studies; D016037:Single-Blind Method; D014148:Tranexamic Acid / Q000627:therapeutic use*
chemical_list: D000933:Antifibrinolytic Agents; D014148:Tranexamic Acid