title: Flexible ureterorenoscopy is safe and efficient for the treatment of kidney stones in patients with chronic kidney disease.
abstract: OBJECTIVE
  To evaluate the outcomes of kidney stone treatment using flexible ureterorenoscopy (f-URS) among patients with chronic kidney disease (CKD).
  
  
  METHODS
  Data of patients who underwent f-URS between January 2009 and December 2012 were collected. Patients were staged according to estimated glomerular filtration rate. Patients with stage ≥ 3 were accepted as having CKD (study group). These patients were matched with a group of patients without CKD (control group). Operative characteristics, complication rates, and third-month success rates were compared.
  
  
  RESULTS
  Overall, 339 patients underwent f-URS and 62 (18.28%) had CKD. Control group constituted of 87 patients. Having a solitary kidney (17.4% vs 3.5%; P = .003) and history of stone intervention (51.6% vs 23%; P = .001) were more common in the CKD group. Similarly, access sheath was more commonly used among patients with CKD (87.1% vs 70.22%; P = .015). Both perioperative (19.35% vs 19.54; P = .372) and postoperative (22.6% vs 16.1%; P = .214) complication rates were similar in patients with and without CKD. Hospitalization time was 25.70 ± 25.62 and 24.5 ± 25 hours (P = .871) for patients with and without CKD, respectively. Although mean third postoperative estimated glomerular filtration rate of patients with CKD did not change significantly (48.16 ± 8.72 vs 49.08 ± 9.26; P = .431), CKD stage of 13 patients shifted from 3 to 2. At the third postoperative month, stone free rate in patients with and without CKD was 87.1% vs 86.2% (P = .875).
  
  
  CONCLUSIONS
  f-URS is a safe and effective procedure in patients with CKD and it is associated with improved overall kidney function.
authors.affiliation: Department of Urology, Bagcilar Training and Research Hospital, Istanbul, Turkey. Electronic address: emrah.yuruk@yahoo.com.
authors.forename: Emrah
authors.initials: E
authors.lastname: Yuruk
authors.affiliation: Department of Urology, Bagcilar Training and Research Hospital, Istanbul, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Binbay
authors.affiliation: Department of Urology, Haseki Training and Research Hospital, Istanbul, Turkey.
authors.forename: Faruk
authors.initials: F
authors.lastname: Ozgor
authors.affiliation: Department of Urology, Haseki Training and Research Hospital, Istanbul, Turkey.
authors.forename: Akif
authors.initials: A
authors.lastname: Erbin
authors.affiliation: Department of Urology, Haseki Training and Research Hospital, Istanbul, Turkey.
authors.forename: Yalcin
authors.initials: Y
authors.lastname: Berberoglu
authors.affiliation: Department of Urology, Bagcilar Training and Research Hospital, Istanbul, Turkey.
authors.forename: Ahmet Y
authors.initials: AY
authors.lastname: Muslumanoglu
mesh_terms: D000368:Aged; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006801:Humans; D007669:Kidney Calculi / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D061214:Patient Safety; D018583:Pliability; D012016:Reference Values; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D020709:Ureteroscopes; D018666:Ureteroscopy / Q000295:instrumentation* / Q000379:methods