title: Percutaneous nephrolithotomy: is distilled water as safe as saline for irrigation?
abstract: OBJECTIVE
  To compare dilutional effect of distilled water with saline solution as an irrigation fluid in percutaneous nephrolithotomy (PCNL).
  
  
  METHODS
  Three hundred twenty eight adult patients (191 men, 137 women) who were candidates for PCNL were randomly assigned into two groups (distilled water, n = 158, group 1; saline solution, n = 162, group 2). Stone size, operation time, irrigation fluid volume, blood hemoglobin level, urea nitrogen, creatinine, sodium and potassium levels were checked before and at 6 and 12 hours after operation.
  
  
  RESULTS
  The mean age of the patients was 37.8 years, and the mean stone diameter was 31.5 mm. There was no clinical case of transurethral resection (TUR) syndrome. Serum sodium depletion was significantly more in group 1 than group 2 (P < .0001). Group 1 had significant decreased post-operative serum sodium levels (P < .0003). Similarly in group 2, postoperative serum sodium levels were significantly lower than the preoperative concentration (P < .01), but it was not the same 6 hours after the operation (P = .23). Serum sodium concentrations remained within normal limits in all cases, without causing clinical signs and symptoms of hyponatremia.
  
  
  CONCLUSIONS
  We found that distilled water is safe irrigation fluid for PCNL in adults. In addition, it is more available and cost effective.
authors.affiliation: Department of Urology, Endourology Division, Urology Nephrology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Mohammad Mehdi
authors.initials: MM
authors.lastname: Hosseini
authors.affiliation: Department of Urology, Endourology Division, Urology Nephrology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. hassanpour74@yahoo.com.
authors.forename: Abbas
authors.initials: A
authors.lastname: Hassanpour
authors.affiliation: Department of Urology, Endourology Division, Urology Nephrology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Farhad
authors.initials: F
authors.lastname: Manaheji
authors.affiliation: Department of Urology,Jahrom University of Medical Sciences, Jahrom, Iran.
authors.forename: Alireza
authors.initials: A
authors.lastname: Yousefi
authors.affiliation: Department of Anesthesiology, Jahrom University of Medical Sciences, Jahrom, Iran.
authors.forename: Mohammad Hassan
authors.initials: MH
authors.lastname: Damshenas
authors.affiliation: Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Sezaneh
authors.initials: S
authors.lastname: Haghpanah
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007010:Hyponatremia / Q000209:etiology; D007669:Kidney Calculi / Q000601:surgery; D008297:Male; D009403:Nephrostomy, Percutaneous / Q000379:methods*; D061646:Operative Time; D012964:Sodium / Q000097:blood*; D012965:Sodium Chloride / Q000009:adverse effects*; D007507:Therapeutic Irrigation / Q000009:adverse effects* / Q000379:methods*; D014867:Water / Q000009:adverse effects*
chemical_list: D014867:Water; D012965:Sodium Chloride; D012964:Sodium