DOI: 10.36347/sjams.2017.v05i02.075

Pages: 683-689

Urolithiasis accounts for 5 to 10% of all the urological conditions. Neglected urolithiasis in fraught with multiple complications such as recurrent urinary tract infections, pyonephrosis and eventual end stage renal damage. Urolithiasis in a patient with renal failure requires a tailor made management. The approach is multifaceted and requires the combined effort of the surgeon and the nephrologist. There are multiple factors which influence the recovery of the renal function post-operatively in these situations. This study aims at studying the outcome of patients with urolithiasis and renal failure. The factors which influence outcome shall also be assessed in this study. Patients with urolithiasis related renal failure (Serum creatinine >1.5mg/dl for men more than 3 months and serum creatinine>1.4mg/dl for 3 months in women) were included in the study. All patients were either stented or underwent percutaneous nephrostomy under ultrasound guidance. Baseline creatinine (<2mg/dl, 2to4mg/dl,>4mg/dl), stone burden ( maximal stone size <3cm and >3cm), duration of symptoms (<6 months,>6months),presence of post-operative UTI, presence of pyonephrosis , trend of creatinine and post obstructive diuresis and parenchymal thickness(<5mm versus >5mm) were the variables assessed. The patients were followed up for 9 months post-operatively. Nephrology consultation was done regarding the presence and management of uremia. 74 patients were included in our study. We found a baseline creatinine >4mg/dl, stone burden >3cm, renal parenchymal thickness<5mm and duration of symptoms >6 months to be factors which influence outcome adversely. A baseline s creatinine >4mg/dl, renal parenchymal thickness < 5mm, duration of symptoms>6 months, presence of post-operative UTI were all detrimental to post-operative renal function.