title: Is percutaneous nephrolithotomy in solitary kidneys safe?
abstract: OBJECTIVE
  To review our experience from a high volume stone center with a focus on efficacy, safety, and renal function.
  
  
  METHODS
  Stones requiring percutaneous nephrolithotomy (PCNL) in patients with solitary kidneys can pose significant anxiety to the urologist. Limited data are available in published reports in this setting. A comprehensive retrospective review of medical records was performed on patients who underwent PCNL and had a solitary kidney or a single functioning renal unit. Data were collected on patient demographics, stone burden, outcomes, complications, and renal function.
  
  
  RESULTS
  Of 378 PCNLs performed between January 2003 and September 2011, 22 were performed in 17 patients with a single functioning kidney. Three procedures were performed in a transplanted kidney. In those with solitary calculus, the longest mean length and stone surface area were 37 mm and 825 mm(2), respectively. Stone-free rate was 59%. Auxiliary procedures were required in 6 cases, resulting in a stone-free rate of 77%. Median inpatient stay was 4 days. Serum creatinine values improved from 144 to 126 umol/L before and after the procedure and mean estimated glomerular filtration rate improved similarly from 51 to 59 mls/minute, respectively. Blood transfusion was required in 1 patient, sepsis developed in 3, and 2 patients required a stent for obstruction.
  
  
  CONCLUSIONS
  PCNL in solitary kidneys is safe with an acceptable complication rate if performed in a high volume center. Outcomes are good, although auxiliary procedures may be necessary. Renal function remains stable or improves after procedure.
authors: The Stone Unit, Department of Urology, Guy's Hospital, Guy's and St. Thomas' NHS Foundation Trust, London, United Kingdom.
authors: Kathie Alexina
authors: KA
authors: Wong
authors: Arun
authors: A
authors: Sahai
authors: Amit
authors: A
authors: Patel
authors: Kay
authors: K
authors: Thomas
authors: Matthew
authors: M
authors: Bultitude
authors: Jonathan
authors: J
authors: Glass
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003404:Creatinine / Q000097:blood; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007668:Kidney / Q000601:surgery*; D007669:Kidney Calculi / Q000601:surgery*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous / Q000009:adverse effects / Q000379:methods*; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D003404:Creatinine