saving a kidney from dialysis (PCNL)

Initially I got a reference from Dr Abeesh that a 43 year old patient who is a poorly controlled diabetic ( very high HbA1c 18%) was admitted with progressively raising S. Creatine from 206 mmol/L (27th May 2020) to 473 mmol/L within 2 days. Pt was investigated with Ultrasound abdomen and noted to have Large left renal calculus 39mm and right pelvic calculus 15mm with both hydronephrosis. In view of Severe Hydronephrosis I advised to get pt for Bilateral DJ stent in view of large stone load causing obstruction and progressive renal failure.
Pt underwent Bilateral DJ stenting on 30th may 2020. 
however He failed to have reduction of Creatine and was again admitted under Dr Abeesh nephrologist  on who prompted helped me for Hemodialysis to save his kidneys.
Under the combined opinion of Dr Abeesh and me , NephroUrology team decided to do Percutaneous Nephrolithotomy of his Better functioning left kidney which was affected with large stone bulk. Pre op Evaluation by CT scan and pre anaesthetic evaluation by our able anesthetist Dr Kuldeep done. 
On 25th July 2020 he underwent Left Percutaneous Nephrolithotomy ( PCNL) with minimal bloos loss in an attempt to save his functioning kidney. we succeeded in this task and finally pt became better after hospital stay of 3 days. To our surprise pt creatine immediately got reduced to 363 mmol/L and his creatine further reduced to 236 mmol/L over short period of 2 week.
thus we were able to save a kidney from going into Dialysis dependance by timely intervention


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