Obstructive Uropathy with Renal Failure
Journal Title: Journal of Clinical and Diagnostic Research - Year 2018, Vol 12, Issue 5
Abstract
ABSTRACT Introduction: Renal failure is often seen with Urinary Tract Obstruction (UTO), which could be acute or chronic (obstructive nephropathy). With early diagnosis and treatment, it is often reversible. The data being sparse in literature, hence this study was planned. Aim: The present retrospective study was undertaken to discuss about causes, pathophysiology, site of obstruction, clinical features, diagnostic tests, management and factors affecting renal failure outcomes in cases of obstructive uropathy. Materials and Methods: All outpatient and inpatient cases of obstructive uropathy in 2016 were included and were subjected for renal function tests, radiological investigations. Stenting, diversion surgeries were performed to relieve obstruction. Student’s t-test, Levene’s test, chi-square/Fisher Exact-test were used for statistical analysis. Results: Of the 107 patients enrolled, bilateral UTO, intrinsic cause, chronic obstruction (>3 months duration), acute on Chronic Kidney Disease (CKD), Acute Kidney Injury (AKI), most common site of obstruction was ureter, seen in 58 (54%), 78 (72%), 71 (66%), 63 (58%), 44 (41%) and 47 (43%) cases respectively. Among co-morbities, history of past Urinary Tract Infection (UTI), past urological surgeries and diabetes mellitus were seen in 70 (65%), 62 (57%), and 62 (57%) cases respectively. Among the aetiology, blood clots, abdomen lymphadenopathy, ureter calculus were seen in 62 (57%), 16 (15%), and 14 (13%) cases respectively. Most common symptom was pain abdomen present in 98 (91%) cases. Among the complications, UTI was seen in 65 (60%). Dialysis therapy and most common urological intervention, ureter stenting was needed in 38 (35%) and 37 (34%) cases respectively. Renal failure recovery, post obstructive diuresis, death were noted in 34 (31%), 25 (23%) and 18 (16%) cases respectively. Conclusion: Comparing with renal failure recovered group, the non recovered group had statistically significant dominant males, were much older, had higher incidence of congenital blocks, acute on CKD, Pelvi-Ureter Junction (PUJ) obstruction, blood clots, abdomen lymphadenopathy, weight loss, abdomen mass, mineral bone disorder, emphysematous Acute Pyelonephritis (APN), lower haemoglobin, leukocytosis, dialysis need and Extracorpeal Shock Wave Lithotripsy (ESWL) therapy.
Authors and Affiliations
Nambakam Tanuja Subramanyam, Girish P Vakrani
Keywords
Related Articles
- EP ID EP522981
- DOI 10.7860/JCDR/2018/34041.11550
- Views 61
- Downloads 0
Giant Sialolith of the Submandibular Gland
Images in Medicine
Cholesterol Management in Indians: Should We Treat the Targets or Treat the Risk?
Abstract Clinical evidence on relationship between cholesterol and Cardiovascular Disease (CVD) has highlighted the importance of all lipid components in the pathogenesis of CVD, thereby generating the concepts of “targe...
Efficacy of Perfusion Computed Tomography (PCT) in Differentiating HighGrade Gliomas from Low Grade Gliomas, Lymphomas, Metastases and Abscess
Introduction: Tumoural angioneogenesis and its quantification are important in predicting the tumour grade and in the management with respect to the treatment available and to assess the response to treatment and the pro...
Outcomes Assessment of Transoral Laser Microsurgery for T1 and T2 Glottic Cancer at the Ho Chi Minh City Ear-Nose-Throat Hospital
ABSTRACT Introduction: Transoral Laser Microsurgery (TLM) has been accepted as a major treatment modality for early glottic carcinoma (T1, T2), with well-known advantages over Radiation Therapy (RT) and open partial lary...
Paracervical Block and Paracetamol for Pain Reduction During IUD Insertion: A Randomized Controlled Study
Introduction: Unintended pregnancies and its consequences are a considerable public health problem. Intrauterine Devices (IUDs) are reversible, safe and effective contraceptive method for most women. Aim: The aim of this...