Objective To identify risk factors of systemic inflammatory response syndrome (SIRS) after percutaneous nephrolithotomy (PCNL).Methods We retrospectively reviewed 438 renal calculi patients after PCNL from August 2015 to July 2016.Among them,there were 251 men and 187 women,the mean age was (49.4 ± 11.1) years.The positive preoperative urine WBC,culture and nitrite rates were 29.7％ (130),12.1％ (53) and 15.1％ (66),respectively.The stone size was (851.2 ± 663.6) mm2,the stone CT value was (960.4 ± 303.4) HU,the operative time was (63.5 ± 33.4) min,124 (28.3 ％) were infection stones and multiple-tracts PCNL was performed in 69 (15.8％) patients.Univariate and multivariate logistic regression analysis were used to analyze perioperative predictors after PCNL.Results Thirty-nine patients developed SIRS (8.9％) after PCNL.The univariate analysis showed that positive preoperative urine WBC,nitrite,culture,operation time,stone size and transfusion had significantly impacts on the outcome of postoperative SIRS after PCNL (P ＜ 0.05).Multivariable logistic analysis showed that positive preoperative urine nitrite (OR =5.990,P ＜ 0.001),stone size (OR =2.251,P =0.027) and transfusion (OR =7.501,P =0.007) were independently related to the postoperative SIRS.Conclusion The positive preoperative urine nitrite,stone size and transfusion are independent risk factors for postoperative SIRS after PCNL.