Renal Functional Recovery and Complication Profile after Ureteroscopic Lithotripsy with Double-J Stenting in Chronic Kidney Disease: A Prospective Single-Centre Study

Abstract

Background: Chronic kidney disease (CKD) amplifies the risks of urolithiasis management by diminishing renal reserve and pre-disposing patients to bleeding and sepsis. Ureteroscopic lithotripsy (URSL) with adjuvant double-J (DJ) stenting is widely adopted to clear stones and secure drainage, yet dedicated evidence in CKD cohorts remains sparse Methods: We performed a prospective, single-centre observational study of adults with CKD stages II–IV undergoing URSL with DJ stent placement (January 2022 – December 2024). Pre-operative variables (demography, CKD stage, stone metrics) and peri-operative details were captured. Primary outcome was, change in renal function—serum creatinine and estimated glomerular filtration rate (eGFR)—from baseline to 3-months. Secondary outcomes included stone-free rate (SFR), complications (Clavien-Dindo), lower-urinary-tract symptoms (LUTS) and length of stay. Statistical significance was set at p < 0.05. Results: Sixty patients (mean age 58.4 ± 10.3 years; 70 % men) were analysed. Mean stone diameter was 12.8 ± 4.2 mm; 63.3 % were ureteric. Mean operative time was 52 ± 15 min. SFR at 4 weeks reached 88 %. The mean serum creatinine decreased significantly from 2.11 ± 0.43 mg/dL (pre-op) to 2.00 ± 0.47 mg/dL (Day 1), 1.89 ± 0.45 mg/dL (Day 7), and 1.74 ± 0.40 mg/dL (3 months) (p < 0.001). Correspondingly, mean eGFR improved from 35.6 ± 11.5 mL/min/1.73 m² to 37.3 ± 11.0, 39.9 ± 11.8, and 44.1 ± 12.6, respectively (p < 0.001). Renal functional improvement was observed as early as Day 1 and progressively increased over 3 months. Complications were limited and manageable, with no Clavien-Dindo Grade III or higher events. No patient required dialysis or nephrectomy. Median hospital stay was 3 (IQR 2–4) days. Conclusion: URSL with DJ stenting is safe and yields meaningful renal recovery in CKD, with high SFR and acceptable morbidity. Vigilant peri-operative infection control remains essential.