Long-term effects of superselective renal artery embolization on renal function after percutaneous nephrolithotomy.

IF 2.8 2区医学 Q2 UROLOGY & NEPHROLOGY World Journal of Urology Pub Date : 2025-01-31 DOI:10.1007/s00345-025-05468-w

Zhican He, Yong Li, Shike Zhang, Hongcan Yang, Zhen Li, Liang Han, Yuhao Zhou, Peng Xu, Tao Zeng, Steffi Kar Kei Yuen, Guohua Zeng, Wenqi Wu

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Abstract

Objectives: To investigate the long-term impact of superselective renal artery embolization (SRAE) on renal function in cases of severe post-percutaneous nephrolithotomy (PCNL) haemorrhage, and to identify the factors associated with the long-term outcome of renal function.

Methods: Patients treated with SRAE for post-PCNL hemorrhage between September 2016 and September 2021 were included. Patients' demographic and clinical data were recorded. Multiple linear regression and logistic regression were used to identify the factors related to the percentages of estimated glomerular filtration rate (eGFR) change and the risk factors of worsening renal function (WRF), respectively.

Result: A total of 80 patients were included. There was no significant change in eGFR before and after SRAE immediately within 1.45 ± 1.66 days (66.37 ± 28.45 vs. 63.86 ± 29.26 mL/min/1.73 m², p = 0.202). Patient's eGFR increased significantly from 66.37 ± 28.45 to 70.94 ± 30.48 mL/min/1.73 m² (p = 0.044) with a mean follow-up of 30.4 months after SRAE, especially in patients with compromised renal function before SRAE (β = 0.297, p = 0.039). However, BMI > 24 kg/m² was significantly associated with the decrease of eGFR (β = -0.343, p = 0.016). 12 (15.0%) patients developed WRF, logistic regression analysis showed that BMI > 24.0 kg/m² (OR = 4.144, p = 0.045) and atrophic renal cortex (OR = 4.180, p = 0.040) were independent risk factors of WRF.

Conclusion: SRAE is an effective treatment for post-PCNL severe haemorrhage, and is not deleterious to long term renal function. Notably, BMI > 24.0 kg/m² and atrophic renal cortex were significant predictors of long-term WRF in SRAE patients.

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研究目的研究超选择性肾动脉栓塞术（SRAE）对经皮肾镜（PCNL）术后严重出血病例肾功能的长期影响，并确定与肾功能长期结局相关的因素：纳入2016年9月至2021年9月期间接受SRAE治疗的PCNL术后出血患者。记录患者的人口统计学和临床数据。采用多元线性回归和逻辑回归分别确定估计肾小球滤过率（eGFR）变化百分比的相关因素和肾功能恶化（WRF）的风险因素：结果：共纳入 80 例患者。在 1.45 ± 1.66 天内立即进行 SRAE 前后，eGFR 无明显变化（66.37 ± 28.45 vs. 63.86 ± 29.26 mL/min/1.73 m²，p = 0.202）。患者的 eGFR 从 66.37 ± 28.45 显著增加到 70.94 ± 30.48 mL/min/1.73 m²（p = 0.044），SRAE 后平均随访 30.4 个月，尤其是 SRAE 前肾功能受损的患者（β = 0.297，p = 0.039）。然而，体重指数大于 24 kg/m2 与 eGFR 的下降显著相关（β = -0.343，p = 0.016）。12例（15.0%）患者出现了WRF，逻辑回归分析显示，BMI > 24.0 kg/m2（OR = 4.144，p = 0.045）和萎缩性肾皮质（OR = 4.180，p = 0.040）是WRF的独立危险因素：结论：SRAE 是治疗 PCNL 术后大出血的有效方法，且不会对长期肾功能造成损害。值得注意的是，体重指数大于 24.0 kg/m2 和萎缩性肾皮质是预测 SRAE 患者长期 WRF 的重要因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

World Journal of Urology 医学-泌尿学与肾脏学

CiteScore

6.80

自引率

8.80%

发文量

317

审稿时长

4-8 weeks

期刊介绍： The WORLD JOURNAL OF UROLOGY conveys regularly the essential results of urological research and their practical and clinical relevance to a broad audience of urologists in research and clinical practice. In order to guarantee a balanced program, articles are published to reflect the developments in all fields of urology on an internationally advanced level. Each issue treats a main topic in review articles of invited international experts. Free papers are unrelated articles to the main topic.