Safety, feasibility, and efficacy of surgical intervention for Urolithiasis in patients with chronic kidney disease: A systematic review

Table 1 Comparative outcomes and follow up of surgical interventions for urolithiasis in chronic kidney disease patients

Ref.	Age range	Number of patients	Type of procedure	Post procedure status	Outcomes	Follow-up
AbdelRazek et al[1]	40-65 (Group A), 45-72 (Group B)	52 (25 in Group A, 27 in Group B)	PNL, SWL	Improvement in kidney function in both groups; PCNL shows better stone-free rates in a single session	Group A (PNL): Higher stone-free rate, fewer complications; Group B (SWL): May require multiple sessions, more complications reported	Stone-free rate measured at follow-up; regular check-ups on kidney function and imaging tests
Ram Dhayal et al[9]	38.9 ± 15.32 (ESWL), 42.12 ± 11.02 (Mini-PCNL), 41.5 ± 13.20 (RIRS)	160 (60 ESWL, 60 Mini-PCNL, 40 RIRS)	Mini-PCNL, RIRS, ESWL	Mini-PCNL has the highest SFR, followed by RIRS and ESWL	Mini-PCNL: 98.3% stone-free rate; RIRS: 85% stone-free rate; ESWL: 76.7% stone-free rate	Follow-up included CT urogram and check-up after 1 month
Dutta et al[11]	Median 59 (mPCNL) and 57 (URS)	101 (51 mPCNL, 50 URS)	Mini-PCNL, URS	Stone-free rate higher in mPCNL using a 2-mm cutoff (76% vs 46%). Residual stone burden was significantly lower in mPCNL group (1.4 mm vs 3.6 mm in URS group)	Higher net revenue and direct costs in mPCNL; no significant difference in complications within 30 days	Follow-up included low-dose CT scan between POD 1-30
Fankhauser et al[13]	URS: 50 (± 13.2), SWL: 47 (±14.7)	44 (23 URS, 21 SWL)	URS, SWL	URS had higher stone-free rate (61%) compared to SWL (48%) after 3 months; URS associated with higher early post-treatment pain	URS: Routine stenting; SWL: No stenting; complications were low in both groups	Pain and stone-free rates assessed at 1, 7, 21 days, and 3 months; additional complications noted
Refaat et al[31]	M-PCNL: 36.93 ± 8.58, S-PCNL: 45.06 ± 10.65	60 (30 M-PCNL, 30 S-PCNL)	Mini-PCNL (M-PCNL), Standard-PCNL (S-PCNL)	M-PCNL had higher stone-free rate (100%) compared to S-PCNL (86.7%); M-PCNL associated with fewer complications, including lower hemoglobin drop and postoperative fever	M-PCNL: Shorter hospital stay, less postoperative pain, fewer complications; S-PCNL: Higher leakage, longer hospital stay	Follow-up included postoperative pain, stone clearance, and complications assessment
Wang et al[41]	SWL: Median 50, URS: Median 54	1230 (998 SWL, 232 URS)	SWL, URS	SWL had an equivalent stone-free rate to URS at 1 month (88.7% vs 83.6%) and 3 months (96.8% vs 98.2%), with fewer complications in SWL, particularly no ureteral injuries observed in SWL	SWL: Shorter hospital stay (1 day vs 2 days) and significantly lower cost compared to URS	Follow-up included assessment at 1 and 3 months for stone-free rate and complications

PNL: Percutaneous nephrolithotomy; ESWL: Extracorporeal shock wave lithotripsy; RIRS: Retrograde intrarenal surgery; CT: Computed tomography; URS: Ureteroscopy.

Table 2 Comparison of stone-free rate, complications, kidney function, operative time and length of hospital stay of surgical interventions for urolithiasis in chronic kidney disease patients

Ref.	Intervention	Stone-free rate	Complications	Effect on kidney function	Operative time (minute)	Hospital stay (days)
AbdelRazek et al[1]	PNL vs SWL	PNL: 84% SWL: 26.6% (1st session), 88.9% (overall)	PNL: 36% bleeding/hematuria SWL: 55.6% complications	Improvement in S. Creatinine and eGFR	PNL: 53.04 ± 7.6 SWL: 51.22 ± 5.5	Not specified
Refaat et al[31]	M-PCNL vs S-PCNL	M-PCNL: 100%. S-PCNL: 86.7%	M-PCNL: 13.3% leakage S-PCNL: 86.7% leakage	M-PCNL: Lower hemoglobin drop	M-PCNL: 133.73 ± 29.18. S-PCNL: 48.6 ± 17.88	M-PCNL: 1.4 ± 0.62. S-PCNL: 3.33 ± 1.21
Dutta et al[11]	mPCNL vs URS	mPCNL: 76%, URS: 46%	No significant differences in 30-day complications	No significant change	Not specified	mPCNL: 1 day URS: Same-day discharge
Ram Dhayal et al[9]	ESWL vs mPCNL vs RIRS	mPCNL: 98.3%. RIRS: 85%. ESWL: 76.7%	ESWL: Fewer complications, mPCNL: More complications but higher stone-free rate	Not specified	ESWL: 136.4 ± 19.3. mPCNL: 32.3 ± 12.65. RIRS: 51.2 ± 8.63	ESWL: 0.13 ± 0.05 mPCNL: 3.07 ± 1.6 RIRS: 3.02 ± 0.65
Fankhauser et al[13]	URS vs SWL	URS: 61%, SWL: 48%	URS: Higher early postoperative pain, SWL: Painful ureteral obstruction in 4%	No significant change	Not specified	Not specified

PNL: Percutaneous nephrolithotomy; ESWL: Extracorporeal shock wave lithotripsy; RIRS: Retrograde intrarenal surgery; CT: Computed tomography; URS: Ureteroscopy.