The effect of standard percutaneous nephrolithotomy, miniaturized percutaneous nephrolithotomy and retrograde intrarenal surgery on biomarkers of renal injury: a randomized clinical trial

ABSTRACT Background Observational studies on the association of endourological procedures with renal parenchymal damage are lacking. This randomized trial examined effect standard percutaneous nephrolithotomy (sPCNL) in comparison miniaturized-PCNL (mini-PCNL) and retrograde intrarenal surgery (RIRS) for nephrolithiasis treatment novel biomarkers injury. Methods Seventy-five patients were a 1:1:1 ratio to receive sPCNL, mini-PCNL RIRS nephrolithiasis. The ratios neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1 (KIM-1) interleukin-18 (IL-18) normalized urinary creatinine (Cr) calculated from urine samples collected at baseline (2-h preoperatively) 2-, 6-, 24- 48-h postoperatively. Two-way mixed analysis variance (ANOVA) repeated measurements was used evaluate effects type procedure time studied biomarkers. Results Between 2-h postoperatively, no significant differences observed NGAL/Cr changes between sPCNL [median (interquartile range) 9.46 (4.82–14.9)], [12.78 (1.69–25.24)] [6.42 (2.61–23.90)] (P = .902). Similarly, between-group KIM-1/Cr .853) IL-18 .980) 2 h, all any time-point Within-groups, increases noted (sPCNL, P < .001; mini-PCNL, RIRS, .001), IL-18/Cr h; progressively lower groups As such, but not evidenced two-way ANOVA. No acute incidence complications. Conclusions under study associated similar patterns early tubular injury, detected by biomarkers, which is largely reduced within 48 h glomerular function.