Chinese expert consensus on preoperative renal function assessment and postoperative internal drainage and follow-up based on renal function considerations for urinary tract stones
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摘要: 尿路结石术前进行肾功能评估的必要性已得到广泛认可。但国内外同行在基于肾功能考量的结石术前检查、术后尿路内引流及随访等方面还存在较多问题尚未达成共识。为进一步规范和指导国内成人尿路结石手术术前肾功能评估、术后尿路内引流及随访，由中华医学会泌尿外科学分会尿路结石学组、中国尿石症联盟牵头组织专家研讨会，参考国内外指南及文献，结合问卷调查，编写了本专家共识，以期为国内同行的临床实践提供参考意见，逐步形成行业规范。Abstract: The necessity for preoperative assessment of renal function for urinary tract stones is widely recognized. However, there are still many issues that have not yet been agreed upon by domestic and international colleagues regarding the preoperative examination, postoperative internal drainage, and follow-up of stones based on renal function considerations. To further standardize and guide the preoperative renal function assessment, postoperative internal urinary drainage, and follow-up of adult urolithiasis surgery in China, the group of Urolithiasis of the Chinese Urological Association(CUA), and the Chinese Alliance of Urolithiasis compiled this expert consensus by organizing an expert workshop, referring to domestic and international guidelines and literature, and carrying out a questionnaire survey. We hoped that this consensus can provide a reference for the clinical practice of domestic counterparts and gradually form an industry standard.
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Key words:
- urinary tract stones operation /
- renal function /
- internal drainage /
- follow-up
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表 1 CKD的分期
K/DOQI对CKD的分期 分期 特征 eGFR/[mL·min-1·
(1.73 m2)-1]Ⅰ GFR正常或者增加 ≥90 Ⅱ GFR轻度下降 60~89 Ⅲa GFR轻到中度下降 45~59 Ⅲb GFR中重度下降 30~44 Ⅳ GFR重度下降 15~29 Ⅴ 肾衰竭 < 15 基于Scr对CKD的分期 分期 特征 Scr Ⅰ 肾功能正常期 Scr维持在正常范围 Ⅱ 肾功能不全的
失代偿期Scr开始升高，但 < 178 μmol/L Ⅲ 氮质血症期 Scr波动在178~445 μmol/L Ⅳ 肾衰竭早期 Scr波动于445~707 μmol/L Ⅴ 肾衰竭 Scr>707 μmol/L，伴随如恶心、呕吐、高钾血症等毒素蓄积症状，需要进行肾脏替代治疗 
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