title: Acute kidney injury after percutaneous nephrolithotomy for stones in solitary kidneys.
abstract: OBJECTIVE
  The aim of this study was to report the incidence, severity, outcome and risk factors of acute kidney injury (AKI) following percutaneous nephrolithotomy (PNL) in solitary kidneys.
  
  
  METHODS
  The study included consecutive adult patients who underwent PNL for treatment of calculi in a solitary kidney between May 2012 and July 2015. Patients with congenital renal anomalies or with stages 4 and 5 chronic kidney disease (CKD) were excluded. Serum creatinine levels were measured the day before PNL, daily after PNL for 2-5 days and after 3 months. AKI was depicted according to changes in early postoperative serum creatinine levels and its severity was determined based on the Acute Kidney Injury Network (AKIN) classification. The outcome of AKI was evaluated after 3 months by changes in the stage of CKD. Univariate and multivariate statistical analyses were conducted to determine risk factors for developing AKI.
  
  
  RESULTS
  The study included 100 patients (62 males) with a mean ± SD age of 50 ± 11.7 years. Complications were reported for 27 patients. AKI developed in 25 patients; at the 3 month follow-up, 23 of them (92%) had completely recovered from AKI and two (8%) had developed stage 4 CKD. Independent risk factors for developing AKI were multiple PNL tracts and postoperative ureteric obstruction (relative risks were 14 and 22, respectively).
  
  
  CONCLUSIONS
  The incidence of AKI was 25% after PNL for a solitary kidney. The likelihood of renal function recovery was 92%. Multiple PNL tracts and postoperative ureteric obstruction were risk factors for developing AKI.
authors.affiliation: a Department of Urology , Urology and Nephrology Center, Mansoura University , Mansoura , Egypt.
authors.forename: Ahmed R
authors.initials: AR
authors.lastname: El-Nahas
authors.affiliation: a Department of Urology , Urology and Nephrology Center, Mansoura University , Mansoura , Egypt.
authors.forename: Diaa-Eldin
authors.initials: DE
authors.lastname: Taha
authors.affiliation: b Department of Anesthesia , Urology and Nephrology Center, Mansoura University , Mansoura , Egypt.
authors.forename: Hussien M
authors.initials: HM
authors.lastname: Ali
authors.affiliation: a Department of Urology , Urology and Nephrology Center, Mansoura University , Mansoura , Egypt.
authors.forename: Ahmed M
authors.initials: AM
authors.lastname: Elshal
authors.affiliation: a Department of Urology , Urology and Nephrology Center, Mansoura University , Mansoura , Egypt.
authors.forename: Mohamed H
authors.initials: MH
authors.lastname: Zahran
authors.affiliation: a Department of Urology , Urology and Nephrology Center, Mansoura University , Mansoura , Egypt.
authors.forename: Nasr A
authors.initials: NA
authors.lastname: El-Tabey
authors.affiliation: a Department of Urology , Urology and Nephrology Center, Mansoura University , Mansoura , Egypt.
authors.forename: Ahmed M
authors.initials: AM
authors.lastname: El-Assmy
authors.affiliation: a Department of Urology , Urology and Nephrology Center, Mansoura University , Mansoura , Egypt.
authors.forename: Ahmed M
authors.initials: AM
authors.lastname: Harraz
authors.affiliation: b Department of Anesthesia , Urology and Nephrology Center, Mansoura University , Mansoura , Egypt.
authors.forename: Hazem E
authors.initials: HE
authors.lastname: Moawad
authors.affiliation: b Department of Anesthesia , Urology and Nephrology Center, Mansoura University , Mansoura , Egypt.
authors.forename: Mahmoud M
authors.initials: MM
authors.lastname: Othman
mesh_terms: D058186:Acute Kidney Injury / Q000097:blood / Q000209:etiology* / Q000503:physiopathology*; D000293:Adolescent; D000328:Adult; D000368:Aged; D003404:Creatinine / Q000097:blood; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007669:Kidney Calculi / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D000074642:Nephrolithotomy, Percutaneous / Q000009:adverse effects*; D011446:Prospective Studies; D051436:Renal Insufficiency, Chronic / Q000209:etiology / Q000503:physiopathology; D012307:Risk Factors; D012720:Severity of Illness Index; D055815:Young Adult
chemical_list: D003404:Creatinine
keywords: Acute kidney injury; percutaneous nephrolithotomy; renal calculi; solitary; stones