Impact of ureteroscopy on renal function in solitary kidneys: a systematic review

Charles Jaouen; Olivier Traxer; Stefano Moretto; Federico Zorzi; Alberto Quarà; Alejandra Bravo-Balado; Letizia Maria Ippolita Jannello; Luigi Candela; Mariela Corrales; Marie Chicaud; Stessy Kutchukian; Bastien Landreat; Zine-Eddine Khene; Thibaut Culty; Souhil Lebdai; Daron Smith; Steeve Doizi; Pierre Bigot; Frédéric Panthier

doi:10.1007/s00345-025-05784-1

Impact of ureteroscopy on renal function in solitary kidneys: a systematic review

World J Urol. 2025 Jun 23;43(1):383. doi: 10.1007/s00345-025-05784-1.

Authors

Charles Jaouen^{1

2

3

4}, Olivier Traxer^{1

2

4

5

6}, Stefano Moretto^{1

2

4

5

7}, Federico Zorzi^{1

2

4

8}, Alberto Quarà^{1

2

4

5

9}, Alejandra Bravo-Balado^{1

2

4

5}, Letizia Maria Ippolita Jannello^{1

2

4

10

11}, Luigi Candela⁴, Mariela Corrales^{1

2

4}, Marie Chicaud^{1

2

12}, Stessy Kutchukian^{1

2

13}, Bastien Landreat^{1

2

4}, Zine-Eddine Khene¹⁴, Thibaut Culty³, Souhil Lebdai³, Daron Smith^{6

15}, Steeve Doizi^{1

2

4

5

6}, Pierre Bigot^{3

16}, Frédéric Panthier^{17

18

19

20

21}

Affiliations

¹ Groupe de Recherche Clinique sur la Lithiase Urinaire, Sorbonne University, Endolase-GRC n°20, Paris, 75020, France.
² PIMM Lab UMR 8006, CNRS-Arts et Métiers ParisTech, 151 bd de l'Hôpital, Paris, 75013, France.
³ Department of Urology, Angers University Hospital, 4 Rue Larrey, Angers, 49100, France.
⁴ Department of Urology, Assistance-Publique Hôpitaux de Paris, Sorbonne University, Tenon Hospital, Paris, 75020, France.
⁵ PIMM, UMR 8006 CNRS-Arts et Métiers ParisTech, 151 bd de l'Hôpital, Paris, 75013, France.
⁶ Endourology Technology Section of European Association of Urology (EAU), Arnhem, The Netherlands.
⁷ Department of Urology, Humanitas Clinical and Research Institute IRCCS, Milan, Italy.
⁸ Department of Medical, Surgical and Health Sciences, Urology Clinic, University of Trieste, Trieste, 34127, Italy.
⁹ Department of Urology, AOU San Luigi Gonzaga - University of Turin, Orbassano, Turin, Italy.
¹⁰ Università degli Studi di Milano, Milan, Italy.
¹¹ Department of Urology, Ospedale Maggiore Policlinico, Foundation IRCCS Ca' Granda, Milan, 20122, Italy.
¹² Service d'Urologie, Centre Hospitalier Universitaire de Limoges, 2 avenue Martin Luther King, Limoges, 87000, France.
¹³ Department of Urology, Poitiers University Hospital, 2 Rue de la Milétrie, Poitiers, 86000, France.
¹⁴ Department of Urology, Rennes University Hospital, 2 Rue Henri le Guilloux, Rennes, 35000, France.
¹⁵ Department of Urology, Westmoreland Street Hospital, UCLH NHS Foundation Trust, London, UK.
¹⁶ Member of Cancerology Committee of the French Association of Urology (CCAFU), maison de l'urologie, 11 rue Viète, Paris, 75017, France.
¹⁷ Groupe de Recherche Clinique sur la Lithiase Urinaire, Sorbonne University, Endolase-GRC n°20, Paris, 75020, France. fredericpanthier@gmail.com.
¹⁸ PIMM Lab UMR 8006, CNRS-Arts et Métiers ParisTech, 151 bd de l'Hôpital, Paris, 75013, France. fredericpanthier@gmail.com.
¹⁹ Department of Urology, Assistance-Publique Hôpitaux de Paris, Sorbonne University, Tenon Hospital, Paris, 75020, France. fredericpanthier@gmail.com.
²⁰ PIMM, UMR 8006 CNRS-Arts et Métiers ParisTech, 151 bd de l'Hôpital, Paris, 75013, France. fredericpanthier@gmail.com.
²¹ Endourology Technology Section of European Association of Urology (EAU), Arnhem, The Netherlands. fredericpanthier@gmail.com.

PMID: 40549268
DOI: 10.1007/s00345-025-05784-1

Abstract

Purpose: This study aimed to assess ureteroscopy's impact on renal function in patients with a solitary kidney (SK), where nephron preservation is paramount. With the rising prevalence of SKs due to congenital anomalies or acquired conditions, understanding the safety profile of ureteroscopy, particularly its effects on renal function, seems essential.

Methods: A literature search following PRISMA guidelines was conducted to identify reports published until May 2024. Eligible studies were included if they focused on ureteroscopy in SK patients and reported renal function outcomes. Data extraction and bias assessment were performed using standardized protocols as Joanna Briggs Institute's checklist for non-randomized studies. Renal function changes (eGFR or serum creatinine), complications, and follow-up data were analyzed. Outcomes included acute kidney injury (AKI) and persistent renal function deterioration, as defined by the Collège-Français-des-Enseignants-d'Urologie (CFEU) criteria.

Results: 15 studies were included, involving 615 patients. The renal function remained stable in ten (67%) of them, with no significant AKI reported beyond one-month post-procedure. Two studies(13%) reported improved renal function, while three(20%) observed trends toward improvement. The mean stone size ranged from 6 to 37.5 mm, with an operative time of 50-117 min. Complications were reported in 22% of patients, predominantly low-grade(Clavien I-II). Severe complications were rare(0.3% and 2%, respectively). The mean follow-up period was 7.5 months.

Conclusion: Ureteroscopy appears to be a viable and safe option for SK patients, presenting minimal risk of long-term renal deterioration. However, only short-term and heterogenous data are available. Future research with standardized methodologies and long-term evaluations are required to validate these findings.

Keywords: Acute kidney injury (AKI); Kidney stones; Nephron preservation; Renal function; Solitary kidney; Ureteroscopy.

Publication types

Systematic Review
Review

MeSH terms

Humans
Kidney Calculi* / surgery
Kidney* / abnormalities
Kidney* / physiopathology
Solitary Kidney* / complications
Solitary Kidney* / physiopathology
Solitary Kidney* / surgery
Ureteroscopy* / adverse effects