Flexible Ureterorenoscopy Is Safe and Efficient for the Treatment of Kidney Stones in Patients With Chronic Kidney Disease

Objective To evaluate the outcomes of kidney stone treatment using flexible ureterorenoscopy (f-URS) among patients with chronic kidney disease (CKD). Patients and Methods Data of patients who underwent f-URS between January 2009 and December 2012 were collected. Patients were staged according to estimated glomerular filtration rate. Patients with stage ≥3 were accepted as having CKD (study group). These patients were matched with a group of patients without CKD (control group). Operative characteristics, complication rates, and third-month success rates were compared. Results Overall, 339 patients underwent f-URS and 62 (18.28%) had CKD. Control group constituted of 87 patients. Having a solitary kidney (17.4% vs 3.5%; P = .003) and history of stone intervention (51.6% vs 23%; P = .001) were more common in the CKD group. Similarly, access sheath was more commonly used among patients with CKD (87.1% vs 70.22%; P = .015). Both perioperative (19.35% vs 19.54; P = .372) and postoperative (22.6% vs 16.1%; P = .214) complication rates were similar in patients with and without CKD. Hospitalization time was 25.70 ± 25.62 and 24.5 ± 25 hours ( P = .871) for patients with and without CKD, respectively. Although mean third postoperative estimated glomerular filtration rate of patients with CKD did not change significantly (48.16 ± 8.72 vs 49.08 ± 9.26; P = .431), CKD stage of 13 patients shifted from 3 to 2. At the third postoperative month, stone free rate in patients with and without CKD was 87.1% vs 86.2% ( P = .875). Conclusion f-URS is a safe and effective procedure in patients with CKD and it is associated with improved overall kidney function.