OBJECTIVES

To describe the demographics of patients undergoing supine PCNL (s-PCNL) and prone PCNL (p-PCNL) at Veterans Memorial Medical Center (VMMC) and to compare different data collected between the two approaches.

Retrospective data collection was done through chart review of patients who underwent supine and prone PCNL at VMMC from 2018 to 2022. Information collected includes patient demographics, clinical profile, stone burden and laterality, surgical technique, hospital days, complications and management.

A total of 176 cases, 132 s-PCNL and 44 p-PCNL, were included. Demographic data show no statistical difference as to age and sex. There is no statistical difference in the stone burden, stone density, and Guy’s stone scores between the two groups. There was no statistical difference in the mean operative time and stone free rates between the two groups. Mean hospital stay was 6.11 days for s-PCNL and 6.76 for p-PCNL, with significant statistical difference in favor of s-PCNL. Complication rates were 15.2% for supine PCNL and 13.6% for prone PCNL. There was no statistical significant difference in Clavien-Dindo complications between the two groups. There was no mortality reported for both groups.

There is an observed increasing trend in the number of supine PCNL versus prone PCNL from 2018 to 2022. Supine PCNL is as effective and safe as prone PCNL. Supine PCNL appears to be more beneficial in terms of hospital stay in days. However, one limitation of the study its being retrospective and collated data which is the cause of the discrepancy in sample population size between the two groups.

The horseshoe kidney results from fusion of the two renal blastema at the time when they lie closeset together, usually at the fifth or sixth weeks of intrauterine life and occurs in 0.25% of the general population. Hydronephrosis, infection, calculus formation and concomitant other malformation are associated in the one third of patients. The duplicated ureter occurs in 6 to 10% congenital associated anomalies. This report concerns a case of rare combination of horseshoe kidney, bilateral duplication of ureter with obstruction of one ureteropelvic junction causing symptomatic hydronephrosis due to renal artery of right low moiety, which was treated with heminephrectomy.
Calculi ; Humans ; Hydronephrosis* ; Kidney* ; Renal Artery ; Ureter*

Replacement lipomatosis of the kidney is a rare disease. It is characterized by fatty replacement of destroyed or atrophic renal parenchyma which associated with inflammatory or noninflammatory renal disease. Herein we reported a case of replacement lipomatosis of the kidney with renal tuberculosis and calculus.
Calculi ; Kidney* ; Lipomatosis* ; Rare Diseases ; Tuberculosis, Renal

Although some recent studies showed that increased synthesis of vasodilatory prostaglandin E2 were possible factor in the maintenance of renal blood flow during the states of impaired renal perfusion. However this fact is not studied in cases of upper urinary tract calculi yet. This study is to estimate the value of urinary prostaglandin E2 in cases of upper urinary calculi. The amount of prostaglandin E2 in urinary excretion was measured by radioimmunoassay in ten cases of complete ureteral obstruction compared with normal side, in eleven cases of partial ureteral obstruction compare with normal side and in three cases of bilateral renal calculi. The results obtained were summerized as follows: 1. The values of urinary prostaglandin E2 were highly elevated in cases of bilateral renal calculi. 2. In ten cases of complete ureteral obstruction, the values of urinary prostaglandin E2 decreased in comparison with those of the normal side. 3. In eleven cases of partial obstructions of the ureter, urinary prostaglandin 2, values were elevated than those of the normal side.
Calculi ; Dinoprostone* ; Kidney Calculi ; Perfusion ; Radioimmunoassay ; Renal Circulation ; Ureter ; Ureteral Obstruction ; Urinary Calculi* ; Urinary Tract

The formation of urinary calculi following renal transplantation is rare event with a frequency of less than 5%. Although infection, renal tubular acidosis and cyclosporine-induced hyperuricosuria can predispose toward stone formation in a renal allograft. The modalities of treatment used, were percutaneous nephrolithotripsy, shock wave lithotripsy and chemolysis. We report a case in which a double-J ureteral stent that had been forgotten for 10 years induced staghorn calculi in allograft. The stone was successfully removed by percutaneous ultrasonic nephrolithotripsy through graft renal pelvis.
Acidosis, Renal Tubular ; Allografts* ; Calculi* ; Kidney Calculi ; Kidney Pelvis* ; Kidney Transplantation ; Lithotripsy ; Shock ; Stents ; Transplants* ; Ultrasonics ; Ureter ; Urinary Calculi

Replacement lipomatosis of kidney which has been recognized as invasion of kidney by fat and extensive replacement of cortex with lipomatous growth, is always associated with kidney infection and with calculus disease of most cases. Lipomatosis in congenital renal hypoplasia is a very rare condition. In a 37 year old female patient suffering from left pyelonephritis, we incidentally found that right kidney was a fuctionless hypoplastic one by serial studies. Right nephrectomy was taken to prevent from possible renal hypertension and other complications. On pathologic examination, right kidney revealed severe replacement lipomatosis on hypoplastic kidney. Herein we report this case with review of some literatures.
Adult ; Calculi ; Female ; Humans ; Hypertension, Renal ; Kidney ; Lipomatosis* ; Nephrectomy ; Pyelonephritis

Urinary obstructions from ureteral calculi are one of the causes of postrenal acute kidney injury (AKI). Here we present a case of AKI caused by a 4 mm ureteral calculus with postobstructive diuresis following the spontaneous passage of the calculus. A 13-year-old girl who underwent nephrectomy for the removal of a neuroblastoma eight years previously, visited our institution because anuria had developed over the preceding five days. The serum creatinine level was elevated at 13.4 mg/dL. Radiological examinations showed the right solitary kidney with moderate hydronephrosis and a 4 mm calculus in the upper right ureter. The patient immediately underwent hemodialysis. After the ureteral calculus was passed spontaneously on day 2 of hospitalization, urinary output increased to more than 5,200 mL per day. Intravenous fluid replacement with careful monitoring of weight, intake, output, and serum and urine electrolytes was performed. On day 5 of hospitalization, the patient's condition stabilized.
Acute Kidney Injury* ; Adolescent ; Anuria ; Calculi ; Creatinine ; Diuresis* ; Electrolytes ; Female ; Hospitalization ; Humans ; Hydronephrosis ; Kidney ; Nephrectomy ; Neuroblastoma ; Polyuria ; Renal Dialysis ; Ureter ; Ureteral Calculi ; Urinary Calculi*

BACKGROUND: Intravenous urography(IVU) has long been accepted as the primary radiologic study for the diagnosis of renal colic. But the IVU does pose disks of contrast material reactions and exposure to radiation. Recently, IVU has been challenged as a first line modality and ultrasonography proposed as a replacement. We, therefore, felt obliged to re-evaluate the IVU, KUB and ultrasonography as diagnostic tools. METHODS: We evaluate the sensitivity and specificity of ultrasound, IVU and KUB in detecting urinary calculi in suspected acute renal colic, a prospective study of 69 patients, both sides of kidney and ureter, who visited urban university hospital emergency center from September 1997 to January 1998. Our sonographic criteria far a positive examination consisted of visualization of urinary tract calculus and/or hydronephrosis and/or urinoma. RESULTS: In Ultrasonography, the accuracy, sensitivity and specificity were 94, 94 and 94%. In IVU and KUB, they were 90, 81, 98% and 71, 43, 96%. CONCLUSION: Ultrasonography is very useful diagnostic tool in initial evaluation of acute renal colic.
Calculi ; Diagnosis ; Emergencies ; Humans ; Hydronephrosis ; Kidney ; Prospective Studies ; Renal Colic* ; Sensitivity and Specificity ; Ultrasonography* ; Ureter ; Urinary Calculi ; Urinary Tract ; Urinoma

OBJECTIVES: In recent years, serious concerns have been raised regarding the impacts of rising temperatures on health. The present study was conducted to investigate the relationship between elevated temperatures and kidney disease through a systematic review and meta-analysis. METHODS: In October 2017, 2 researchers independently searched related studies in PubMed and Embase. A meta-analysis was conducted using a random-effects model, including only studies that presented odds ratios, relative risks, or percentage changes, along with 95% confidence intervals (CIs). The characteristics of each study were summarized, and the Egger test and funnel plots were used to evaluate publication bias. RESULTS: Eleven studies that met the criteria were included in the final analysis. The pooled results suggest an increase of 30% (95% CI, 20 to 40) in kidney disease morbidity with high temperatures. In a disease-specific subgroup analysis, statistically significant results were observed for both renal colic or kidney stones and other renal diseases. In a study design–specific subgroup analysis, statistically significant results were observed in both time-series analyses and studies with other designs. In a temperature measure–specific subgroup analysis, significant results were likewise found for both studies using mean temperature measurements and studies measuring heat waves or heat stress. CONCLUSIONS: Our results indicate that morbidity due to kidney disease increases at high temperatures. We also found significant results in subgroup analyses. However, further time-series analyses are needed to obtain more generalizable evidence.
Hot Temperature ; Infrared Rays ; Kidney Calculi ; Kidney Diseases ; Kidney ; Odds Ratio ; Publication Bias ; Renal Colic

Xanthogranulomatous pyelonephritis is a chronic inflammatory condition that can only be diagnosed by histological examination, and is often associated with renal calculi, obstruction and urinary tract infection. We report a case of bilateral xanthogranulomatous pyelonephritis in a child with end stage renal disease, which was misdiagnosed as renal cell carcinoma preoperatively.
Carcinoma, Renal Cell ; Child* ; Humans ; Kidney Calculi ; Kidney Failure, Chronic ; Pyelonephritis, Xanthogranulomatous* ; Urinary Tract Infections