Browsing by Author "Samuel Fekadu"

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    Short and Long-Term Renal Function Trajectories and Associated Factors Following Ultrasound Guided Percutaneous Nephrolithotomy (Pcnl) Assessed by Estimated Glomerular Filtration Rate
    (Addis Ababa University, 2025-10-01) Samuel Fekadu; Abeselom Lemma; Fitsum Solomon
    Background: Percutaneous Nephrolithotomy (PCNL) is the Treatment of choice for large and Complex Renal Stones. Information Regarding Stone Clearance Outcomes are Well Established. But, Data on Short- and Long-Term Renal Function Changes After PCNL Procedure, Particularly in Low Resource Settings Is Limited. Objective: Assess Short- and Long-Term Renal Function Pattern After A PCNL Procedure and Identify Factors Associated with Change in Estimated Glomerular Filtration Rate (Egfr) Among Patients Managed at Tikur Anbessa Specialized Hospital Between September 1, 2023 and October 30, 2024 Methods: A Retrospective Cohort Study Was Conducted. A Prospectively Collected Data from a Previous Research Was Supplemented by Electronic Medical Record Review and Analysis Was Done. Patient’s Aged ≥15 Years Were Included. Renal Function Was Assessed Using Egfr (CKD-EPI 2021) At Baseline, 72 Hours, 3 Months, 6 Months, And 12 Months. Longitudinal Egfr Changes Were Analyzed Using Linear Mixed-Effects Models with Multiple Imputation for Missing Predictor Data. Results: 100 Patients Were Included in the Study with Mean Age 41.2 ± 12.8 Years And 67% Male Were Male. Mean Egfr Showed a Transient, Non-Significant Decline At 72 Hours Followed by Progressive Recovery, Exceeding Baseline Values At 12 Months By +5.68 Ml/Min/1.73 M² (P = 0.034) Which Was Not Significant When It Was Adjusted for Other Factors. Old Age and Presence of Comorbidities Were Independently Associated with Lower Egfr at Baseline but Has No Significant Impact on the Patter of Egfr During Follow-Up. Significant Effect of Hydronephrosis and CKD Was Seen on the Pattern of Egfr. Presence of Moderate to Severe Hydronephrosis Showed Poor Recovery Whereas Patients with CKD Stages 3 And 4 Showed Significant Relative Improvement over time. Operative factors were Nnt Independently Associated with Long-Term Renal Function. Conclusion: PCNL Results in a Transient Early Postoperative Decline Followed by Recovery and Long-Term Preservation or Improvement in Most Patients, having no Net Effect on Renal Function. Baseline Renal Function and Hydronephrosis Severity Primarily Determine Postoperative Renal Function Pattern.