Inclusion Criteria:  Adult patients with age group ≥ 18 years old with renal stones candidate for PCNL with pre-operative estimated GFR less than 90 ml/min/1.7 m2 and ≥ 15 ml/min/1.7 m2  Exclusion Criteria:  Patients with chronic renal failure on regular dialysis. Patients with bleeding diathesis. Patients who are unfit for surgery. Pregnancy Patients who are refusing the participation in our study.