Acute kidney injury following supine mini-PNL versus retrograde intrarenal surgery in patients with renal stones < 3 cm: a prospective comparative study

Abstract

Background: The purpose of the current study was to prospectively compare mini-PNL and RIRS for development of acute kidney injury (AKI), success, and complication rates in a cohort of patients with kidney stones less than 3 cm. Methods: In this prospective study, data of 60 consecutive patients underwent mini-PNL (n=31) or RIRS (n=29) was investigated. Urinary NGAL levels were measured preoperatively and at postoperative 6th hour to evaluate AKI. Success and complication rates were also compared. Results: The mean stone size was signifcantly higher in the mini-PNL group (24.6 mm vs. 18.2 mm, p=0.02). The mean postoperative NGAL levels were 45.6±12.4 and 48.1±13.6 for the mini-PNL and RIRS groups, respectively. The increase was statistically signifcant for both groups (p: 0.01). The diference between the two groups for mean postoperative NGAL measurements was not statistically signifcant (p=0.47). The SFR was signifcantly higher in the miniPNL group (96.7% vs. 79.3%, p=0.04). The complication rates were similar for the two groups (p=0.99). The mean duration of operation was 48.2±22.5 min in the mini-PNL group and 62.6±18.1 min in the RIRS group (p=0.03). The median duration of hospitalization was 1 day for both groups. Conclusions: In patients with renal stones<3 cm in diameter, mini-PNL in supine position provides higher SFR and shorter operative times with similar rates of complications and AKI when compared with RIRS. Mini-PNL should be considered as the primary treatment option together with RIRS for renal stones and should not be ruled out for being a more invasive option.