慢性腎臟病患中血紅素與血液肌酸酐之比例可預測迷你經皮腎造瘻取石手術術後之腎功能惡化
劉佳旻、陳偉安、劉展榮
1. 成功大學附設醫院泌尿科2.成功大學醫學院

The predictive value of hemoglobin to serum creatinine ratio for renal function deterioration in chronic kidney disease patients after miniaturized percutaneous nephrolithotomy

Chia-Min Liu^1*,Wei-An Chen^2*, Chan-Jung Liu ¹

1. Department of Urology, National Cheng Kung University Hospital, Tainan, 704302, Taiwan
2. School of Medicine, College of Medicine, National Cheng Kung University, Tainan, 704302, Taiwan

Purposes

With the rising use of miniaturized percutaneous nephrolithotomy (mPCNL), the effect of the procedure on renal function gains significance, especially in chronic kidney disease (CKD) patients. We aimed to explore the association between hemoglobin (Hb) to serum creatinine (Cr) ratio, which reflects the combined effect of anemia and renal insufficiency, and postoperative renal function deterioration in CKD patients receiving mPCNL.

Material and Methods: This retrospective observational cohort study included patients with CKD who underwent mPCNL between July 2018 to January 2023. Renal function decline was defined as shifting to a higher CKD stage post-operatively. Comparison was made between patients with deteriorated or improved renal function. Various variables were assessed for association and predictability for renal function decline.

Results:114 patients were categorized by CKD stage shift post-operatively. Over 632 days, 36 patients (31.5%) had renal function deteriorated. The Hb to Cr ratio was significantly lower in the deteriorated group (10.35 ± 3.49 mg/dL vs. 13.39 ± 4.50 mg/dL). In multivariate analysis, only Hb to Cr ratio remained significantly correlated with renal decline (OR 0.85, p = 0.002). Receiver operative characteristic curve analysis of Hb to Cr ratio yielded an area under curve of 0.749, superior to Hb and Cr respectively, suggesting a better predictive value in postoperative renal function decline.

Conclusions: The Hb to Cr ratio could be a simple index to predict renal function decline after mPCNL, with lower ratios indicating an increased likelihood of poorer renal outcomes following the surgery.