Background: Urolithiasis, the third most common urological disease is one of the oldest disease known to mankind  affecting  both  males  and female in  a  proportion  of approximately 2:1.¹ It  is very frequently seen disease in recent times, with an increasing incidence and prevalence, with a significant economic impact associated with its treatment. Although there are numerous reports about the end results, its effects on renal functions are not well studied quantitatively. Renal dysfunction due to an obstructing renal or urinary tract calculus improves or resolves upon the timely removal by the appropriate method. However, stone-removing procedures may have a negative impact on renal function through direct or indirect mechanisms.⁵

Aims and Objectives: To study the renal function changes in patients of renal calculus disease who will undergo Urological Intervention(s), assess the factors that influence the post procedural renal function change (s) following the urological intervention and evaluate the Outcomes of Percutaneous Nephrolithotomy compared to Shock Wave Lithotripsy on renal function changes.

Materials and Methods: This is Hospital based descriptive study conducted in Department of Medicine and Urology, RIMS, Imphal during September 2016 to August 2018 amongst patient admitted in the Medicine/ Urology department in the age group of 18 years or more, with renal stone disease for Urological interventions during the study period

Results: It was concluded that renal function does not change post urological intervention & that patients presenting with kidney stone disease & renal insufficiency experience higher likelihood of renal function deterioration after treatment of calculous disease. It was also observed comorbidities like hypertension, diabetes or anaemia were not significant predictors or determinants of postoperative renal function deterioration. There was also improvement of hydronephrosis post intervention.

Keywords: Renal Functions, Urolithiasis, Nephrolithotomy.

1. Lancina MJA, Rodriguez-Rivera  GJ, Novas  CS, Rodriguez GI, Fernandez RE, Alvarez CL et al. Metabolic risk factors in calcium urolithiasis according to gender and age of the patients. ActaUrolEsp 2002;26:111-20.
2. Trinchieri A. Epidemiology Arch  ItalUrolAndrol 1996;68:203-50.
3. Marak A, Shantibala K, Singh TA, Singh RKN, Singh LS. Urolithiasis: Prevalence and related factors in a rural area of Manipur. Int J Med Sci Public Health 2013;2:956-9.
4. Singh PP, Singh LBK, Prasad SN, Singh MG. Urolithiasis in Manipur (north eastern  region  of  India)  Incidence  and chemical  composition  of    Am J ClinNutr 1978;31:1519-25.
5. Zhong P, Tong HL, Cocks FH, Preminger GM.Transient oscillation of cavitation bubbles nearstone surface during electrohydraulic lithotripsy. J Endourol 1997;11:55-61.
6. Pearl MS, Lotan Y. Urinary Lithiasis: Etiology, Epidemiology & Pathogenesis. In: Wein AJ, Kavoussi LR, Novick AC, Partin AW,Peters CA, editors. Campbell-Walsh Urology. 10^th Philadelphia: Saunders Elsevier; 2012. p. 1257-86.
7. Ranabir S, Baruah MP, Devi KR. Nephrolithiasis: Endocrine evaluation. Ind J EndocrMetab 2012;16:228-35.
8. Michael Ordon. The Surgical Management of Kidney Stone Disease in the Province of Ontario: A Population Based Time Series Analysis [dissertation]. Toronto: University of Toronto;2013.
9. McAteer JA, Evan AP. The acute and long-term adverse effects of shock wave lithotripsy. SeminNephrol 2008;28(2):200-13.
10. Wood K, Keys T, Mufarrij P. Impact of Stone Removal on Renal Function: A Review. Rev Urol 2011;13(2):73-89.
11. Agrawal MS, Agarwal K, Jindal T, Sharma M. Ultra-mini percutaneous nephrolithotomy: A minimally-invasive option for percutaneous stone removal. Ind J Urol 2016;32:132-6.
12. Desai J, Zeng G, Zhao Z, Zhong W, Chen W, Wu W. A novel technique of ultra-mini-percutaneous nephrolithotomy: Introduction and an initial experience for treatment of upper urinary calculi less than 2 cm. Biomed Res Int 2013;2013(490793):[6 pages]. Available from: hptt://dx.doi.org/10.1155/2013/490793. Accessed May 02,2018.
13. Handa RK, Johnson CD, Connors BA, Goa S, Evan AP, Miller NL, et al. Renal functional effects of simultaneous bilateral single-tract percutaneous access in pigs. BJU Int 2010;105:125-8.
14. Saxby MF. Effects of percutaneous nephrolithotomy and extracorporeal shock wave lithotripsy on renal function and prostaglandin excretion.Scand J UrolNephrol 1997;31:141-4.
15. Urivetsky M, Motola J, King L, Smith AD. Impact of percutaneous renal stone removal on renal function: assessment by urinary lysozyme activity. J Urol 1989;33:305-8.
16. Cass SA. Renal Function after Extracorporeal Shock Wave Lithotripsy to a Solitary Kidney. J Endourol 1994;8(1):15-9.
17. Moskovitz B, Halachmi S, Sopov V, Burbara J, Horev N, Groshar D, Nativ O. Effect of Percutaneous Nephrolithotripsy on Renal Function: Assessment with Quantitative SPECT of 99mTc-DMSA Renal Scintigraphy. J Endourol 2006;20(2):102-6.
18. Aminsharifi A, Irani D, Masoumi M, Goshtasbi B, Mohamadian R. The management of large staghorn renal stones by percutaneous versus laparoscopic versus open nephrolithotomy: a comparative analysis of clinical efficacy and functional outcome. Urolithiasis [serial online] 2016;online first. Available from: hptt://link.springer.com/article10.1007%2Fs00240-0160-0877-6. Accessed May 26,2018.
19. Daggüllia M, Utangaça MM, Dedea O. Potential biomarkers for the early detection of acute kidney injury after percutaneous nephrolithotripsy. J Endourol 2008;22(5):151-6.
20. Unsal A, Koca G, Reşorlu B, Bayindir M, Korkmaz M. Effect of Percutaneous Nephrolithotomy and Tract Dilatation Methods on Renal Function: Assessment by Quantitative Single-Photon Emission Computed Tomography of Technetium-99m–Dimercaptosuccinic Acid Uptake by the Kidneys. J Endourol2010;24(9):1497-502.
21. Aminsharifi A, Alavi M, Sadeghi G, Shakeri S, Afsar F. Renal Parenchymal Damage After Percutaneous Nephrolithotomy with One-Stage Tract Dilation Technique: A Randomized Clinical Trial. J Endourol 2011;25(6):927-31.
22. Kukreja R, Desai M, Patel SH, Desai MR. Nephrolithiasis Associated with Renal Insufficiency: Factors Predicting Outcome. J Endourol 2004;17(10):875-9.
23. Kuzgunbay B, Umit G, Tahsin T, Tulga E. Long-Term Renal Function and Stone Recurrence After Percutaneous Nephrolithotomy in Patients with Renal Insufficiency. J Endourol 2010;24(2):305-8.
24. Fayad AS, Elsheikh MG, Mosharafa A, El-Sergany R, Abdel-Rassoul MA, Elshenofy A, Ghamrawy H. Effect of Multiple Access Tracts During Percutaneous Nephrolithotomy on Renal Function: Evaluation of Risk Factors for Renal Function Deterioration. J Endourol 2014;28(7):775-9.
25. Pérez-Fentes D, Cortés J, Gude F, García C, Ruibal A, Aguiar P. Does percutaneous nephrolithotomy and its outcomes have an impact on renal function? Quantitative analysis using SPECT-CT DMSA. Urolithiasis 2014;42(5):461-7.
26. Jindal T, Mandal SN, Sonar P, Kamal MR, Ghosh N, Karmakar D. Analysis of urinary stone composition in Eastern India by X-ray diffraction crystallography. Adv Biomed Res 2014;3:203.
27. EvanAP, Willis LR, Lingeman JE, McAteer JA. Renal trauma and the risk of long-term complications in shock wave lithotripsy. Nephron 1998;78:1-8.
28. Gilbert BR, Riehle RA, VaughanED. Extracorporeal shock wave lithotripsy and its effect on renal function. J Urol 1988;139:482-85.
29. McAteer JA, Evan AP. The acute and long-term adverse effects of shock wave lithotripsy. Semin Nephrol 2008;28(2):200-13.
30. Thomas R, Roberts J, Sloane B, Kaack Effect of extracorporeal shock wave lithotripsy on renal function. J Endourol 1988;2(2):141-44.
31. Willis LR, Evan AP, Connors BA, Shao Y, Blomgren PM, Howard JP, et al. Shockwave lithotripsy: Dose-related effects on renal structure, hemodynamics, and tubular function. J Endourol 2005;19(1):90-101.
32. Hao P, Li W, Song C, Yan J, Song B, Li L. Clinical evaluation of double-pigtail stent in patients with upper urinary tract diseases: report of 2685 cases. J Endourol 2008;22(1):65-70.
33. Al-Kohlany KM, Shokeir AA, Mosbah A, Mohsen T, Shoma AM, Eraky I, et al.Treatment of complete staghorn stones: a prospective randomized comparison of open surgery versus percutaneous nephrolithotomy. J Urol 2005;173:469-73.
34. Preminger GM, Clayman RV, Hardeman SW, Franklin J, Curry T, Peters PC. Percutaneous nephrostolithotomyvs open surgery for renal calculi: A comparative study. JAm Med Assoc 1985;254:1054-8.
35. Liou LS, Streem SB.Long-term renal functional effects of shock wave lithotripsy, percutaneous nephrolithotomy and combination therapy: A comparative study of patients with solitary kidney. J Urol 2001;166:33-7.
36. Lingeman JE, Woods J, Toth PD, Evan AP, Mcateer JA.The role of lithotripsy and its side effects.J Urol 1989;141:793-7.
37. Gupta S, Wadhwa P, Minocha VR. Renal function response following percutaneous nephrolithotomy in patients of renal stone disease with impaired renal function. Int J Nutr Manag 2002;17(1):18-20.
38. Richter S, Ringel A, Shalev M, Nissenkorn I. The indwelling ureteric stent: A friendly procedure with unfriendly high morbidity. Br JUrolInt2000;85:408-11.
39. Mokhmalji H, Braun PM, Portillo FJM, Siegsmund M, Alken P, Kohrmann KU. Percutaneous nephrostomy versus ureteral stents for diversion of hydronephrosis caused by stones: A prospective, randomized clinical trial. J Urol 2001;165:1088-92.

Dr Rothangpui

Address: A-77, Zone III, National Games Village, Imphal-795004, Manipur, India