Objective: To investigate the significance of change of urine microalbumin/urine cretinine (mALB/Ucr) in nephrolithiasis patients with renal dysfunction (experimental group) before and after percutaneous nephrolithotomy (PCNL).
Methods: mALB/Ucr value and serum cretinine (Scr) value were analyzed in 21 nephrolithiasis patients with renal dysfunction before PCNL, and 1, 7, 30 and 90 days after PCNL. Operative time and the number of tract were recorded and analyzed in the experimental group. The same work was done in 27 nephrolithiasis patients with normal renal function (control group) before surgery.
Results: The levels of mALB/ Ucr in experimental group patients before PCNL were significantly higher than those in control group (P<0. 001) . The levels of mALB /Ucr between 7 days after operation and 30 days (P=0.054) or 90 days (P=0.062) after operation were not statistically significant. The levels of Scr of 30 days after operation in experimental group were lower than those of 7 days after surgery (P<0.001); But they were not statistically significant compared with those of 90 days after surgery (P=0.106). The mALB/Ucr difference between before PCNL and 7 days after PCNL (ΔmALB/Ucr) was positively correlated to the number of operation tract (r=0.486,P=0.030), but it was not correlated to operation time (r=0.323, P=0.129). The ΔmALB/Ucr was not correlated to Scr difference between before PCNL and 7 days after PCNL (r=0.323, P=0.153). Actually the ΔmALB/Ucr was correlated to Scr difference between before PCNL and 30 days (r=0.632, P=0.002), or 90 days (r=0.476, P=0.003) after PCNL.
Conclusion: The damage to kidney filtration of experimental group was more severe than that of control group. The mALB/Ucr or Scr level of experimental group trends to be stable in 7 or 30 days after operation. Increasing operation tracts (less than 3 tracts) can help to restore kidney filtration function. A reliable assessment, of a long-term outcome of the patients' renal function can be reached, by calculating the patients' ΔmALB/Ucr in the experimental group.