Percutaneous Nephrolithotomy and Its Effect on Filtration Function of Kidney: a Critical Appraisal

There are various surgical options for management of renal calculi. PCNL (percutaneous nephrolithotomy) and RIRS (retrograde intrarenal surgery) are minimally invasive treatment options. As PCNL breaches anatomical planes of kidney, it can be associated with a decrease in GFR. We reviewed medline data to evaluate effect of PCNL on decrease in GFR (glomerular filtration rate). Very few studies were found focusing on this aspect. Review of all available studies revealed that there is a decrease in GFR post PCNL. Effect of RIRS on GFR has not yet been adequately studied. PCNL involves a breach in anatomical planes of the kidney leading to decrease in GFR, besides attendant complications of early and delayed bleeding. PCNL breaches anatomical structure of kidney, is basically a grade 4 renal trauma and is found to have a definite effect on fall in GFR.