Objective: To evaluate whether renal parenchymal thickness (RPT) has an effect on the outcomes of percutaneous nephrolithotomy (PNL). Methods: We performed a retrospective analysis of 144 patients with lower pole and/or renal pelvic stones who underwent PNL. The relationship between RPT and peri- and postoperative measures was evaluated. Results: The average age was 45.94 ± 14.47 (15-76) years. The mean BMI was calculated as 27.47 ± 4.73 (16.9-44.9) kg/m2. The mean stone burden was 293 ± 126 (150-800 mm2). The mean RPT was measured as 17.33 ± 5.32 (6-35) mm. No correlation was detected between the RPT and the operation or fluoroscopy times or the duration of hospitalization (p = 0.63, 0.52, 0.08, respectively). The mean drop in hemoglobin level was 1.45 ± 1.25 (0-9) g/dl. A negative correlation was detected between hemoglobin drop and RPT (p = 0.01, r = -0.23). However, the RPT was similar in patients who did or did not require a blood transfusion (p = 0.09). The RPT was found to have no impact on success rate (p = 0.4). Conclusion: The postoperative hemoglobin drop increases in parallel with the increase in RPT. However, no relationship was detected between the RPT and blood transfusion, overall success rate or any other perioperative parameters.

1.
Goodwin WE, Casey WC, Woolf W: Percutaneous trocar (needle) nephrostomy in hydronephrosis. J Am Med Assoc 1955;157:891-894.
2.
Fernström I, Johansson B: Percutaneous pyelolithotomy. A new extraction technique. Scand J Urol Nephrol 1976;10:257-259.
3.
Tiselius HG, Ackermann D, Alken P, et al: Guidelines on Urolithiasis. Arnheim, European Association of Urology, 2007.
4.
De la Rosette J, Assimos D, Desai M, et al: The Clinical Research Office of the Endourological Society Percutaneous Nephrolithotomy Global Study: indications, complications, and outcomes in 5,803 patients. J Endourol 2011;25:11-17.
5.
Steinberg PL, Semins MJ, Wason SE, Matlaga BR, Pais VM: Fluoroscopy-guided percutaneous renal access. J Endourol 2009;23:1627-1631.
6.
Kukreja R, Desai M, Patel S, Bapat S, Desai M: Factors affecting blood loss during percutaneous nephrolithotomy: prospective study. J Endourol 2004;18:715-722.
7.
Cockcroft DW, Gault MH: Prediction of creatinine clearance from serum creatinine. Nephron 1976;16:31-41.
8.
Tepeler A, Binbay M, Yuruk E, Sari E, Kaba M, Muslumanoglu AY, Tefekli A: Factors affecting the fluoroscopic screening time during percutaneous nephrolithotomy. J Endourol 2009;23:1825-1829.
9.
Rassweiler JJ, Renner C, Eisenberger F: The management of complex stones. BJU Int 2000;86:919-928.
10.
Tefekli A, Ali Karadag M, Tepeler K, et al: Classification of percutaneous nephrolithotomy complications using the modified Clavien grading system: looking for a standard. Eur Urol 2008;53:184-190.
11.
De la Rosette JJ, Opondo D, Daels FP, et al: Categorisation of complications and validation of the Clavien score for percutaneous nephrolithotomy. Eur Urol 2012;62:246-255.
12.
Binbay M, Sari E, Tepeler A, et al: Characteristics of patients requiring double-J placement because of urine leakage after percutaneous nephrolithotomy. J Endourol 2009;23:1945-1949.
13.
Kaplon DM, Lasser MS, Sigman M, Haleblian GE, Pareek G: Renal parenchyma thickness: a rapid estimation of renal function on computed tomography. Int Braz J Urol 2009;35:3-8.
14.
Khalaf IM, Shokeir AA, El-Gyoushi FI, Amr HS, Amin MM: Recoverability of renal function after treatment of adult patients with unilateral obstructive uropathy and normal contralateral kidney: a prospective study. Urology 2004;64:664-668.
15.
Beland MD, Walle NL, Machan JT, Cronan JJ: Renal cortical thickness measured at ultrasound: is it better than renal length as an indicator of renal function in chronic kidney disease? AJR Am J Roentgenol 2010;195: W146-W149.
16.
Chou YH, Chen MT, Huang CH: The correlation between ultrasound-detected renal parenchymal thickness and isotope-detected individual renal function. Kaohsiung J Med Sci 1997;13:682-684.
17.
Feder MT, Blitstein J, Mason B, Hoenig DM: Predicting differential renal function using computerized tomography measurements of renal parenchymal area. J Urol 2008;180:2110-2115.
18.
Parvex P, Pippi-Salle JL, Goodyer PR: Rapid loss of renal parenchyma after acute obstruction. Pediatr Nephrol 2001;16:1076-1079.
19.
Chevalier RL, Goyal S, Kim A, Chang AY, Landau D, LeRoith D: Renal tubulointerstitial injury from ureteral obstruction in the neonatal rat is attenuated by IGF-1. Kidney Int 2000;57:882-890.
20.
Aboutaleb H, El-Shazly M, Badr Eldin M: Lower Pole midsize (1-2 cm) calyceal stones: outcome analysis of 56 cases. Urol Int 2012;89:348-354.
21.
Amer T, Ahmed K, Bultitude M, Khan S, Kumar P, De Rosa A, Khan MS, Hegarty N: Standard versus tubeless percutaneous nephrolithotomy: a systematic review. Urol Int 2012;88:373-382.
22.
Shen P, Liu Y, Wang J: Nephrostomy tube-free versus nephrostomy tube for renal drainage after percutaneous nephrolithotomy: a systematic review and meta-analysis. Urol Int 2012;88:298-306.
23.
De la Rosette JJ, Laguna MP, Rassweiler JJ, Conort P: Training in percutaneous nephrolithotomy - a critical review. Eur Urol 2008;54:994-1001.
24.
Sampaio FJ, Zanier JF, Aragao AH, Favorito LA: Intrarenal access: three-dimensional anatomical study. J Urol 1992;148:1769-1773.
25.
Segura JW, Patterson DE, LeRoy AJ, et al: Percutaneous removal of kidney stones: review of 1,000 cases. J Urol 1985;134:1077-1081.
26.
Stoller ML, Wolf JS Jr, St Lezin MA: Estimated blood loss and transfusion rates associated with percutaneous nephrolithotomy. J Urol 1994;152:1977-1981.
27.
Liatsikos EN, Kapoor R, Lee B, Jabbour M, Barbalias G, Smith AD: ‘Angular percutaneous renal access'. Multiple tracts through a single incision for staghorn calculous treatment in a single session. Eur Urol 2005;48:832-837.
28.
Akman T, Binbay M, Sari E, et al: Factors affecting bleeding during percutaneous nephrolithotomy: single surgeon experience. J Endourol 2011;25:327-333.
29.
Tefekli A, Kurtoglu H, Tepeler K, et al: Does the metabolic syndrome or its components affect the outcome of percutaneous nephrolithotomy? J Endourol 2008;22:35-40.
30.
Turna B, Nazli O, Demiryoguran S, Mammadov R, Cal C: Percutaneous nephrolithotomy: variables that influence hemorrhage. Urology 2007;69:603-607.
31.
Tomaszewski JJ, Smaldone MC, Schuster T, Jackman SV, Averch TD: Factors affecting blood loss during percutaneous nephrolithotomy using balloon dilation in a large contemporary series. J Endourol 2010;24:207-211.
32.
Yamaguchi A, Skolarikos A, Buchholz NP, et al: Operating times and bleeding complications in percutaneous nephrolithotomy: a comparison of tract dilation methods in 5,537 patients in the Clinical Research Office of the Endourological Society Percutaneous Nephrolithotomy Global Study. J Endourol 2011;25:933-939.
33.
Falahatkar S, Neiroomand H, Akbarpour M, Emadi SA, Khaki N: One-shot versus metal telescopic dilation technique for tract creation in percutaneous nephrolithotomy: comparison of safety and efficacy. J Endourol 2009;23:615-618.
34.
Amjadi M, Zolfaghari A, Elahian A, Tavoosi A: Percutaneous nephrolithotomy in patients with previous open nephrolithotomy: one-shot versus telescopic technique for tract dilatation. J Endourol 2008;22:423-425.
35.
Gonen M, Istanbulluoglu OM, Cicek T, Ozturk B, Ozkardes H: Balloon dilatation versus Amplatz dilatation for nephrostomy tract dilatation. J Endourol 2008;22:901-904.
36.
Davidoff R, Bellman GC: Influence of technique of percutaneous tract creation on incidence of renal hemorrhage. J Urol 1997;157:1229-1231.
37.
Safak M, Gogus C, Soygur T: Nephrostomy tract dilation using a balloon dilator in percutaneous renal surgery: experience with 95 cases and comparison with the fascial dilator system. Urol Int 2003;71:382-384.
38.
Ganpule AP, Mishra S, Desai MR: Multiperc versus single perc with flexible instrumentation for staghorn calculi. J Endourol 2009;23:1675-1678.
39.
Chan DY, Jarrett TW: Mini-percutaneous nephrolithotomy. J Endourol 2000;14:269-273.
40.
Smith AD: Percutaneous punctures - is this the endourologist's turf? J Urol 1994;152:1982-1983.
41.
El-Nahas AR, Shokeir AA, El-Assmy AM, et al: Post-percutaneous nephrolithotomy extensive hemorrhage: a study of risk factors. J Urol 2007;177:576-579.
42.
Wang Y, Jiang F, Wang Y, Hou Y, Zhang H, Chen Q, Xu N, Lu Z, Hu J, Lu J, Wang X, Hao Y, Wang C: Post-percutaneous nephrolithotomy septic shock and severe hemorrhage: a study of risk factors. Urol Int 2012;88:307-310.
43.
Maghsoudi R, Etemadian M, Shadpour P, Radfar MH, Ghasemi H, Shati M: Number of tracts or stone size: which influences outcome of percutaneous nephrolithotomy for staghorn renal stones? Urol Int 2012;89:103-106.
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