Surgery in patients with renal stones and mild to moderate renal failure reduces the need for dialysis/renal replacement therapy.
These were the implications of a prospective study by investigators from the Department of Urology, All India Institute of Medical Sciences, New Deli, India. Dr Iqbal Singh and colleagues set out to evaluate the efficacy and outcome of surgical intervention in patients with renal stones and chronic renal failure.
Complete follow-up data was available in 70 of 90 patients operated on for staghorn or calyceal calculi. Pyelo-nephrolithotomy was carried out in 63 patients and percutaneous nephrolithotomy in seven patients. Some patients had residual stones; in nine out of the 15 of these extracorporeal shock-wave lithotripsy was successful. The average pre-operative serum creatinine was 4.79 mg/dl. By the ninth post-operative month the average fall in serum creatinine values was 1.53 mg/dl (32 percent). In addition, the average functional improvement by renal dynamic scans stood at 20.665 per cent. The investigators said that 41 patients were saved from the need for further dialysis.
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