Comparative Study of Hemodynamic Changes in Prone Position in Normal Versus Chronic Kidney Disease Patient in Percutaneous Nephrolithotomy Surgery

Background: Percutaneous nephrolithotomy is commonly performed in the prone position, which can lead to significant hemodynamic alterations. Patients with chronic kidney disease may respond differently due to underlying cardiovascular and autonomic changes.

Objective: To compare hemodynamic changes in prone position between normal patients and chronic kidney disease patients undergoing percutaneous nephrolithotomy.

Methods: A prospective randomized study was conducted on 100 patients divided into two groups of 50 each: normal patients and chronic kidney disease patients. Hemodynamic parameters including heart rate, systolic blood pressure, diastolic blood pressure, and mean arterial pressure were recorded at baseline, after induction, immediately after prone positioning, and at regular intervals intraoperatively.

Results: Both groups showed a decline in hemodynamic parameters following prone positioning; however, the reduction was significantly greater in normal patients compared to chronic kidney disease patients. CKD patients demonstrated higher baseline values and relatively stable intraoperative parameters. The differences were statistically significant at multiple time intervals.

Conclusion: Prone positioning during percutaneous nephrolithotomy causes significant hemodynamic changes, with more pronounced effects observed in normal patients. Chronic kidney disease patients exhibit relative hemodynamic stability, likely due to compensatory physiological mechanisms. Careful monitoring is essential to ensure perioperative safety