Postoperative Renal Functional Changes Assessed By Tc-99m-Dtpa Scintigraphy And Predictive Factors After Miniaturized Percutaneous Nephrolithotomy And Retrograde Intrarenal Surgery: An Observational 1-Year Follow-Up Study

Purpose: We evaluated the comparative effect of miniaturized percutaneous nephrolithotomy (mini-PCNL) and retrograde intrarenal surgery (RIRS) on perioperative kidney function by use of diethylenetriamine penta-acetic acid (Tc-99m-DTPA) scintigraphy and identified significant predictors associated with deterioration or amelioration of renal function after surgery.Materials and Methods: All 70 patients who underwent mini-PCNL or RIRS between 2012 and 2016 were monitored by Tc-99m-DTPA scintigraphy preoperatively. Patients with abnormal renal function were monitored from 3 to 12 months postoperatively. Logistic regression analyses were conducted to estimate the predictors of aggravated renal dysfunction and improvement.Results: The difference in preoperative renal function between the contralateral and the operative side was >10% in 57 patients (81.4%). Among those in the group with abnormal renal function, 40 (70.2%),10 (17.5%), and 7 (12.3%) patients showed stability, deterioration, and improvement in renal function at postoperative year 1, respectively. Functional changes did not differ according to the type of surgery. A high level of serum creatinine preoperatively (p=0.060) and a history of previous stone procedures (p=0.051) showed borderline significance for prediction of deterioration in renal function.Conclusions: RIRS and mini-PCNL had similar effects and favorable outcomes on renal function during a 1-year follow-up period. High baseline serum creatinine levels and a history of procedures warrant careful attention.