Comparison of the Effects of Multiple Retrograde Intrarenal Surgery and Single Access Coventional Percutaneous Nephrolithotomy Operation on Early Acute Kidney Injury

Objective: This study compares the impact of multiple sessions of retrograde intrarenal surgery (RIRS) and a single access conventional percutaneous nephrolithotomy (PCNL) on acute kidney injury (AKI) in patients with nephrolithiasis. Materials and Methods:Patients who underwent multiple RIRS within 3 months, in the same renal unit and single access PCNL operations between January 2018 and December 2023, were retrospectively included in the study.Patients were compared in terms of demographic (age, gender, body mass index, comorbidities) and clinical (stone volume, stone size, stone density, stone location, and operation time) characteristics.Serum creatinine levels were measured in the preoperative period and on the first postoperative day in all patients, and estimated glomerular filtration rates (eGFR) was calculated.The mean creatinine values were calculated and evaluated in patients who underwent multiple RIRS.The data were analyzed comparatively.Results: Two hundred one patients underwent PCNL, and 163 patients underwent multiple RIRS.Of the patients who underwent RIRS, 148 underwent two surgeries, ten underwent three surgeries, four underwent four surgeries, and one underwent five surgeries.AKI developed in 6 (3.0%) PCNL patients and 3 (5.2%)RIRS patients within 48 hours of surgery.The demographic and operational results of the patients were statistically comparable (p>0.05).In PCNL cases, the rise in creatinine and the decrease in eGFR were greater than in RIRS cases; however, no statistically significant difference was seen (p=0.054 and p=0.057, respectively). Conclusion:Multiple RIRS and single-access PCNL are comparable regarding AKI.Repeated RIRS is a feasible method for large kidney stones, that can be used safely, like PCNL, in suitable patients.