Abstract:

Objective：To evaluate the risk factors of systemic inflammatory response syndrome (SIRS) in the patients with type 2 diabetes diagnosed with kidney stone after percutaneous nephrolithotomy (PCNL). Methods: In this study, 461 patients with type 2 diabetes who received PCNL in Peking University People’s Hospital from June 2006 to December 2015 were reviewed. There were 281 males and 180 females with an average age of 57 years were included, of whom, 137 were diagnosed with SIRS after PCNL. The demographic data, clinical features, and test results were compared between the patients with SIRS and without SIRS, trying to identify the correlation between their clinical characters and the occurrence of SIRS.  Results: The SIRS was significantly correlated with the patients’ preoperative white blood cell counting (×109/L) ［7.76 (4.00-17.96) vs. 6.31 (2.00-17.40), P<0.001］, preopera-tional blood glucose level (mmol/L) ［7.30 (3.08-19.90) vs. 6.40 (3.42-16.78), P<0.001］, operative time (min) ［75 (20-270) vs. 60 (20-200), P<0.001］, length of stay (d) ［12 (2-46) vs. 11 (3-29), P=0.019］, staghorn stones ［38.8% (33/85) vs. 27.7% (104/376), P=0.042］, and preoperational urinary tract infection ［36.8% (50/136) vs. 26.6% (81/304), P=0.032］. There was no significant correlation between the SIRS and the patients’ age, body mass index, preoperative hemoglobin level, preoperative serum creatinine, and transfusion. In multivariate analysis, abnormal preoperative white blood cell counting (OR=3.194, 95% CI: 1.531-6.666, P=0.002), operative time longer than 60 min (OR=1.635, 95% CI: 1.088-2.456, P=0.018), and preoperational blood glucose level higher than normal 7.1 mmol/L were significantly correlated with the presence of SIRS. Conclusion: The high level of preoperational blood glucose, abnormal preoperative white blood cell counting, and long operative time were significantly correlated with the presence of SIRS in patients with type 2 diabetes after PCNL.

Key words: Nephrostomy, percutaneous, Systemic inflammatory response syndrome, Diabetes mellitus, type 2, Blood glucose