This study evaluates the impact of chronic kidney disease (CKD) stages on stone-free rates (SFR) and renal function outcomes after percutaneous nephrolithotomy (PCNL). Additionally, it examines the predictive role of the CROES and Guy's Stone Score (GSS) systems.
Data from 2994 patients who underwent PCNL between 2007 and 2024 were retrospectively analyzed. Patients were classified into four CKD groups based on preoperative estimated glomerular filtration rate (eGFR). SFR, complication rates, and postoperative renal function changes were assessed.
SFR was significantly lower in advanced CKD stages (p < 0.001), with the lowest in Group A (GFR < 30, 64.1%) and highest in Group D (GFR > 90, 79.1%). Postoperative eGFR increased in CKD stage 4-5 but declined in normal kidney function groups. Complication rates were higher in advanced CKD stages (p = 0.031). CROES and GSS scores correlated with stone complexity and surgical outcomes (p < 0.001).
Advanced CKD is associated with lower SFR, greater surgical complexity, and higher complication rates. PCNL remains an effective treatment, particularly in CKD patients, with potential postoperative renal function improvement. Utilizing predictive scoring systems can optimize patient selection and surgical planning. Further prospective studies are needed to validate these findings.
BMC urology. 2025 Mar 31*** epublish ***
Nebil Akdogan, Mehmet Zubaroglu, Mehmet Gürkan Arıkan, Ismail Onder Yilmaz, Mutlu Deger
Department of Urology, Faculty of Medicine, Cukurova Unıversity, Adana, Turkey., Tarsus State Hospital, Mersin, Turkey. .