Abstract
Background: Percutaneous nephrolithotomy (PCNL) was a very effective and less risky technique for the removal of bigger or more intricate kidney stones. Objective: This study was focused on assessing the clinical outcomes associated with percutaneous nephrolithotomy complications as well as determining the predictive value of risk factors outcomes. Patients and methods: 77 patients who underwent percutaneous kidney stone removal surgery, aged between (20-50) years, were collected from different hospitals in Iraq for a period from March 5, 2022, to November 25, 2023. Moreover, we recorded patients' data during and after the percutaneous nephrolithotomy (PCNL) surgery in terms of duration of operation, puncture site, duration of hospital stays, success rate, duration of nephrostomy, number of cases admitted to the intensive care unit, mortality rate, and duration of recovery. This study aimed to determine the rate of complications, pain, quality of life, and the prognostic value of risk factors affecting patients after surgery. Results: The current study showed that males had an average rate of 47 cases, which was considered more than females, with 30 cases. The most common symptoms were back pain, and 18 patients had fluctuating pain intensity. Locations of kidney stones: 26 patients were in the Staghorn stone, 22 patients were in the renal calyx, 17 patients were in the renal calyx, and 12 patients were in the ureter. Blood WBC was 8.42 ± 2.73 [*10^9/L], Hemoglobin (gm/dL). It was 15.6 ± 1.2, the duration of the surgical procedure was 131.8 ± 64.5 minutes, the duration of stay in the hospital was 4.3 ± 2.6 days, the rate of clinical complications included 5 cases, the most common of which were bleeding and infection, which included two cases each, the mortality rate was zero, the duration of recovery and follow-up each. It was usually a month. The most prominent criteria beyond the health quality of life for patients were physical function, which included 92.75 ± 5.60, and psychological function, which included 91.87 ± 3.91. Conclusion: Percutaneous kidney stone removal (PCNL) technique is considered the most effective and high-quality technique in reducing complications and improving the quality of life for patients.
The main causes include primary glomerulonephritis, chronic pyelonephritis, hypertension, atherosclerosis, diabetic nephropathy, secondary glomerulonephritis, tubulointerstitial disease, hereditary kidney disease, long-term use of antipyretics and analgesics, exposure to heavy metals, etc. .
- Efforts should be made to clarify the cause of chronic renal failure. It should be clarified whether the renal damage is primarily glomerular damage, renal tubulointerstitial lesions, or renal vascular lesions, so that targeted treatment can be based on clinical characteristics. .
- Reversible factors that promote the progressive deterioration of renal function in chronic renal failure should be identified, such as infection, drug-induced kidney damage, metabolic acidosis, dehydration, heart failure, blood pressure falling too quickly or too low, etc.
- Attention should be paid to looking for certain factors that aggravate the gradual deterioration and decline of kidney function in chronic renal failure, such as hypertension, hyperlipidaemia, hypercoagulability, high-protein food intake, massive proteinuria