Impact of Percutaneous Nephrolithotomy (PCNL) on renal cortical function evaluated by 99mTc-DMSA scintigraphy: A single-centre study.

Abstract

Objective: To determine the mean change in split renal cortical function before and three months after Percutaneous Nephrolithotomy (PCNL), using 99mTc-DMSA scintigraphy in patients undergoing the procedure at a single tertiary care centre. Study Design: Quasi-experimental study. Setting: Sindh Institute of Urology and Transplantation (SIUT). Period: February 19 to August 18, 2022. Methods: Enrolling 127 patients through non-probability consecutive sampling. All included patients underwent unilateral single-tract PCNL. Written informed consent was obtained from all participants. Each patient underwent a preoperative DMSA scan. To assess changes in split renal function on the operated side, both preoperative and postoperative DMSA scans were analysed. Results: The mean age of the participants was 44.90 ± 10.63 years. Of the total, 45 patients (35.43%) were female and 82 (64.57%) were male. Regarding the laterality of surgery, 47 patients (37.01%) underwent PCNL on the left kidney, while 80 patients (62.99%) had the procedure on the right. Comparison of split renal function before and after PCNL revealed a significant improvement: the mean preoperative value was 38.59 ± 7.10%, whereas the postoperative mean was 41.84 ± 6.73% (p < 0.001). Conclusion: Technetium-99m DMSA scintigraphy provides a reliable, non-invasive method to assess individual renal cortical function. This study demonstrates that PCNL does not significantly impair the treated kidney. In fact, a statistically significant improvement in split renal function was observed following stone removal.