Manejo endourológico en riñón único: ¿es la nefrolitotomía percutánea un procedimiento seguro para litos complejos?

Introduction: Urolithiasis in a solitary kidney is a significant endourological challenge, any procedures to kidney or its drainage can lead to significant morbidity. There is no international consensus for its management. Procedure selection should be based on stone burden, comorbidities, and complications. Objectives: To describe the clinical characteristics, complications, and stone-free rates of patients with solitary kidneys and complex renal stones from July 2017 to September 2023. Materials and methods: A descriptive, retrospective study was conducted on patients with solitary kidneys and renal stones classified as GUY III and IV treated with PCNL. Continuous variables were expressed as means ± standard deviation. T-Student or U-Mann-Whitney tests, χ², Spearman or Pearson correlations, and ANOVA were utilized as appropriate. A P-value <0.05 was considered statistically significant. Results: a total of 318 records were analyzed, of which 26 patients were included, with 84.6 % being female and a mean age of 45.15 years. All patients had a history of previous episodes of renal lithiasis. The mean stone burden was 984.92 mm3, with a STONE SCORE of 9.3. The stone-free rate was 30.8 % after a single procedure, with Clavien-Dindo I complications in 15.38 % of cases and renal function improvement in 57.7 %. Stone burden, Stone Score, and stone density were significantly associated with the stone-free rate. Conclusion: PCNL emerges as one of the most effective and safest techniques with few complications for complex stones in solitary kidney patients, with minimal impact on renal function