Murat ŞAHAN, Mehmet Erhan AYDIN, Serkan YARIMOĞLU, Ömer KORAŞ, Salih POLAT, Fatih GOKALP, Serdar ÇELİK

Bazal Böbrek Fonksiyon Rezervine Göre Perkütan Nefrolitotominin Böbrek Fonksiyonları Üzerine Erken ve Geç Etkileri

Amaç: Bu çalışmada, perkütan nefrolitotominin böbrek fonksiyonları üzerindeki erken ve geç etkisini preoperatif glomerular filtrasyon hızı düzeylerine göre araştırmayı amaçladık. Gereç ve Yöntemler: Ocak 2012 ve Kasım 2016 arasında perkütan nefrolitotomi uygulanan 351 hasta çalışmaya dahil edildi. Preoperatif glomerular filtrasyon hızına göre hastalar üç gruba ayrıldı: Grup-1 glomerular filtrasyon hızı > 90, Grup-2 glomerular filtrasyon hızı = 60-90, Grup-3 glomerular filtrasyon hızı <60 seviyelerindeki hastalardan oluşmaktaydı. Glomerular filtrasyon hızı ölçümleri ameliyat öncesi, postoperatif 1. gün ve 3. ayda yapıldı. Bulgular: Postoperatif 1. günde, ortalama glomerular filtrasyon hızı grup 1 ve grup 2'de anlamlı olarak azalmışken, grup 3'te anlamlı olarak azalmamıştır. 3. aydaki ortalama glomerular filtrasyon hızı, grup 1 ve grup 2'de preoperatif düzeylere göre düşük saptandı, ancak bu istatistiksel olarak anlamlı değildi. Bununla birlikte, grup 3'ün ortalama glomerular filtrasyon hızı preoperatif düzeylere göre istatistiksel olarak anlamlı derecede arttı. Sonuç: Glomerular filtrasyon hızı, böbrek fonksiyonlarının iyi bir göstergesidir ve perkütan nefrolitotomi prosedüründen önemli ölçüde etkilenir. Böbrek travma prosedürü nedeniyle perkütan nefrolitotomi sonrası böbrek fonksiyonu azalmış olsa da, böbrek taşı nedeniyle ameliyat olan hastalarda postoperatif 3. ayda böbrek fonksiyonu iyiye gider. Bu nedenle perkütan nefrolitotomi, böbrek taşına bağlı preoperatif glomerular filtrasyon hızı <60 olan hastalarda böbrek fonksiyonlarını önemli ölçüde iyileştirdi.

Anahtar Kelimeler:

Perkutan nefrolitotomi, Böbrek taşı, Glomeruler filtrasyon hızı, Kreatinin klirensi

Early and Late Effects of Percutaneous Nephrolithotomy on Renal Functions According to Basal Renal Function Reserv

Objective: In this study, we aimed to investigate the early and late effect of percutaneous nephrolithotomy on renal function based on preoperative glomerular filtration rate levels. Material and Method: Between January 2012 and November 2016, 351 patients who underwent percutaneous nephrolithotomy were included. According to the preoperative glomerular filtration rate, patients were divided into three groups: group 1 was consists of glomerular filtration rate >90 levels; group 2 was consists of glomerular filtration rate levels between 60-90; group 3 was consists of glomerular filtration rate <60 levels. Glomerular filtration rate measure¬ments were performed preoperatively, at post-operative 1st day and 3rd month. Results: On postoperative 1st day, mean glomerular filtration rate was significantly decreased in group 1 and group 2, non-significantly decreased in group 3. At 3rd month, the mean glomerular filtration rate was again decreased compared to preoperative levels in group 1 and group 2 but this time it was statistically non-significant. However, mean glomerular filtration rate of group 3 was statistically significantly increased compared to preoperative levels. Conclusions: Estimated glomerular filtration rate, as a better indicator of renal function, is significantly affected by the percutaneous nephrolithotomy procedure. Although, firstly renal function decreased after percutaneous nephrolithotomy because of the renal trauma procedure, kidney function is better at postoperative 3rd month because of the disappearance of kidney stone . So percutaneous nephrolithotomy was significantly improved the renal functions in patients with preoperative glomerular filtration rate < 60 due to renal stone.

Keywords:

Percutaneous nephrolithotomy, Renal stone, Glomerular filtration rate, Creatinine clearance,

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