Acute Kidney Injury Following Mini Percutaneous Nephrolithotomy for Renal Stones: predictors and Follow-up Evaluation in Real-life Setting

PURPOSE: To evaluate the prevalence, predictors, and progression of acute kidney injury (AKI) in patients undergoing mPCNL for nephrolithiasis. MATERIALS AND METHODS: We retrospectively analyzed data from 569 patients who underwent mPCNL at a single tertiary academic center (01/2016-10/2024). AKI was defined per KDIGO criteria as sCr increase >0.3 mg/dL or ≥1.5× baseline. Stone-free status was no residual stones on CT at 3-month follow-up. Complications were classified using the modified Clavien system. Kidney function was reassessed 30-90 days post-op. Descriptive statistics, logistic regression, and Cox regression were applied. RESULTS: Median (IQR) age and stone volume were 57 (48-66) years and 2.1 (0.9-4.2) cm³. Median preoperative sCr and operative time were 0.9 (0.7-1.1) mg/dL and 90 (73-120) minutes. Post-mPCNL, 40 patients (7.0%) developed AKI. Complications occurred in 138 (24.2%) patients; 449 (78.9%) were stone-free. AKI patients had higher CCI (1.3 vs. 0.5, p=0.04), pre-op sCr (1.1 vs. 0.8 mg/dL, p