PREDICTION OF ACUTE KIDNEY INJURY FOLLOWING ENDOUROLOGICAL MANAGEMENT OF KIDNEY STONES

Abstract

Background: Acute kidney injury (AKI) is a recognized complication of endourological procedures for kidney stones. Early identification of high-risk patients can guide perioperative management and reduce renal morbidity.

Objective: To evaluate the incidence and predictors of AKI in patients undergoing endourological management of kidney stones at Sheikh Zayed Hospital, Lahore.

Methods: A prospective observational study was conducted on 250 adult patients undergoing percutaneous nephrolithotomy (PCNL) or ureterorenoscopy (URS) between January 2022 and December 2023. Demographic, clinical, and operative data were collected, including age, sex, comorbidities, baseline renal function, stone size, and operative parameters. AKI was defined according to KDIGO criteria. Logistic regression analysis identified independent predictors of AKI.

Results: AKI occurred in 31 patients (12.4%). Incidence was higher in PCNL (19.6%) than URS (8.2%). Multivariate analysis revealed baseline serum creatinine >1.2 mg/dL (OR 3.12, 95% CI 1.54–6.32), diabetes (OR 2.45, 95% CI 1.12–5.34), and operative duration >90 minutes (OR 2.87, 95% CI 1.41–5.83) as independent predictors. Multiple tracts in PCNL showed a trend toward increased risk (OR 2.18, 95% CI 0.91–5.22).

Conclusion: AKI is a notable complication following endourological management of kidney stones. Preoperative assessment, optimization of comorbidities, and careful operative planning are essential for minimizing renal injury.