Analysis of influencing factors in acute kidney injury after minimally invasive surgery for upper urinary tract stones
Objective:To analyze the risk factors in acute kidney injury(AKI)after minimally invasive surgery for upper urinary tract stones.Methods:Eight hundred and fifty-two cases of upper urinary tract calculi in Second Affiliated Hospital of Nanjing Medical University from January 2018 to December 2022 treated by minimally inva-sive procedure(rigid/flexible ureteroscope and percutaneous nephroscope)were analyzed.The general clinical data and perioperative data of the patients were collected.According to KDIGO guidelines,the patients with AKI were counted,and the influencing factors in AKI after minimally invasive surgery for upper urinary tract calculi were analyzed.Results:Eighty cases of AKI(9.4％)occurred after the operation of upper urinary tract stones,inclu-ding 64 cases of stage Ⅰ(7.5％),14 cases of stage Ⅱ(1.6％),and 2 cases of stage Ⅲ(0.2％).There were sig-nificant differences between AKI and non AKI groups in BMI,hypertension,diabetes,male ratio and preoperative Cr(P＜0.05),while there were no significant differences in age,positive urine culture,triglycerides,total cho-lesterol,or BUN values(P＞0.05).The incidence of AKI after rigid ureteroscopy was significantly lower than that after flexible ureteroscopy and percutaneous nephroscopy(P＜0.05).Postoperative inflammation levels(WBC,PLT,Neu,CRP and PCT)significantly increased.The differences in surgical time,stone length,and re-sidual stone rate between AKI and non AKI groups were also markedly significant(P＜0.05).Conclusion:BMI,preoperative renal dysfunction,prolonged surgical time,occurrence of intraoperative infections,and high stone burden or residual stone rate are associated with a higher incidence of postoperative AKI.
NETL
NSTL
万方数据
