Kidney Calculi, Nephrolithiasis, Urinary Tract Infections
Conditions
Keywords
Percutaneous nephrolithotomy, PCNL, Infection stones, Struvite stones, Dioxidine, Intrarenal instillation, Stone recurrence, Metaphylaxis
Brief summary
Kidney stone recurrence, particularly infection-related stones, remains a significant clinical problem after percutaneous nephrolithotripsy (PCNL). Bacterial colonization and persistent infection are recognized contributors to stone recurrence. This study evaluates the effectiveness of intrarenal dioxidine instillation as a metaphylactic measure to reduce recurrence of infection-related kidney stones following PCNL. Patients undergoing PCNL will receive standard treatment, with or without adjunctive intrarenal dioxidine administration. The study aims to assess whether this approach reduces stone recurrence and infection-related complications.
Detailed description
Infection-related kidney stones are associated with urease-producing bacteria and carry a high risk of recurrence even after successful surgical removal. Percutaneous nephrolithotripsy (PCNL) is the standard treatment for large or complex renal calculi; however, residual infection and bacterial biofilms may contribute to recurrent stone formation. Metaphylaxis strategies targeting infection control may reduce recurrence rates. Dioxidine is an antimicrobial agent with broad-spectrum activity against gram-positive and gram-negative bacteria and has been used locally in urological practice. Intrarenal instillation may help reduce bacterial colonization in the collecting system. The purpose of this study is to evaluate the clinical effectiveness and safety of intrarenal dioxidine instillation as a metaphylactic intervention after PCNL for infection-related kidney stones. Outcomes include stone recurrence, urinary tract infection rates, and postoperative complications. The results may help define improved metaphylaxis strategies for patients with infection-related nephrolithiasis.
Interventions
DRUGDioxidine
Intrarenal instillation of dioxidine solution after PCNL to reduce bacterial colonization and prevent recurrence of infection-related stones.
PROCEDUREPercutaneous Nephrolithotripsy (PCNL)
Standard percutaneous nephrolithotripsy procedure for removal of kidney stones.
Sponsors
West Kazakhstan Marat Ospanov Medical University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Intervention model description
Participants are assigned to receive standard PCNL with or without adjunctive intrarenal dioxidine instillation.
Eligibility
Sex/Gender
ALL
Age
18 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
Age ≥18 years Patients undergoing percutaneous nephrolithotripsy (PCNL) Infection-related kidney stones Ability to provide written informed consent
Exclusion criteria
Age \<18 years Pregnancy or breastfeeding Known hypersensitivity to dioxidine Severe renal insufficiency or end-stage renal disease Severe comorbid conditions that preclude participation
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Recurrence of infection-related kidney stones | 12 months post-PCNL | Proportion of patients with recurrent infection-related kidney stones within 12 months after percutaneous nephrolithotripsy, assessed by imaging studies (ultrasound or CT) and clinical evaluation. |
Countries
Kazakhstan
Contacts
CONTACTTalgat A Imzharov
STUDY_DIRECTORBazylbek S Zhakiev, MD
West Kazakhstan Marat Ospanov Medical University
Outcome results
None listed