ACR Appropriateness Criteria® Radiologic Management of Urinary Tract Obstruction

Scheidt, Matthew J.; Hohenwalter, Eric J.; Pinchot, Jason W.; Ahmed, O.; Bjurlin, Marc A.; Braun, Aaron R; Kim, Charles Y.; Koepsel, Erica M. Knavel; Schramm, Kristofer; Sella, David M.; Weiss, Clifford R.; Lorenz, Jonathan M.

doi:10.1016/j.jacr.2020.01.039

Cited by 2 publications

(2 citation statements)

References 83 publications

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“…[4] According to the evidence-based guidelines of the American College of Radiology Appropriateness Criteria, these treatments include conservative drug treatment, retrograde ureteral stent placement, or percutaneous nephrostomy or nephroureteral catheter placement. [5] These treatments also include catheterization and cystostomy, which are commonly used to relieve lower urinary tract obstructions. However, new risk factors may occur during the recovery of renal function, and increased urine volume can result from water and electrolyte disturbances caused by diuresis after obstruction, including uric acid disturbances.…”

Section: Introductionmentioning

confidence: 99%

Relieving urinary tract obstructions may increase the risk of gouty arthritis in patients with hyperuricemia and postrenal obstructions

Li,

Yue,

Wang

et al. 2024

Medicine

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To evaluate the effect of relieving urinary tract obstructions (RUO) on the risk of gouty arthritis in patients with postrenal obstructions and hyperuricemia. We retrospectively analyzed the clinical data of 130 patients with urinary tract obstructions at Rongcheng People’s Hospital from 2018 to 2021. Patients were divided into groups A (n = 62) and B (n = 68) according to the treatment method. Patients in group A underwent conservative treatments, such as drugs, extracorporeal shock wave lithotripsy (ESWL), and hemodialysis. Patients in Group B underwent catheterization, cystostomy, nephrostomy, or double J ureteral catheterization for rapid RUO. The ages of groups A and B were 58.40 ± 17.69 and 59.63 ± 16.12 years, respectively (P = .42). Before treatment, the serum uric acid values were 572.05 ± 106.93 and 567.79 ± 97.21 µmol/L, respectively (P = .94); serum creatinine values were 226.66 ± 269.67 and 280.15 ± 200.75 µmol/L, respectively (P = .88); and urine volumes were 913.23 ± 481.92 and 886.18 ± 552.72 mL/24 h, respectively (P = .08). No significant differences in the general data were identified between the two groups (P > .05). The effects of the two treatments on the incidence of gout in patients with hyperuricemia complicated by postrenal obstruction were compared based on changes in uric acid level, creatinine level, and urine volume within 1 week after treatment. Multivariate logistic regression analysis was used to analyze clinical factors that increased the incidence of gout after RUO. The gout incidence rates in group A before and after treatment were 8.1% (5/62) and 6.5% (4/62), respectively (P > .99). The gout incidence rates in group B before and after treatment were 4.4% (3/68) and 19.1% (10/68), respectively (P = .01). Group B had a statistically significant increase in the gout incidence rate after RUO (P < .05). Multivariate logistic regression analysis showed that having an age > 60 years, urine volume ≤400 mL/24 h, and creatinine level > 186 µmol/L before treatment were risk factors for gout in patients with hyperuricemia after RUO. Relieving urinary tract obstruction increases the risk of gouty arthritis in patients with hyperuricemia and acute postrenal obstruction. Age, urine volume, and creatinine levels before treatment are risk factors for gout in patients with hyperuricemia after RUO.

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Section: Introductionmentioning

confidence: 99%

Relieving urinary tract obstructions may increase the risk of gouty arthritis in patients with hyperuricemia and postrenal obstructions

Li,

Yue,

Wang

et al. 2024

Medicine

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“…Symptomatic kidney stones account for the vast majority of urological disorders reported in the emergency department (ED) (1)(2)(3). Urinary tract obstruction (UTO) might be an unpleasant consequence of trapped stones, which can deteriorate renal function when left untreated (4). Stone-mediated UTO could be detected through non-contrast computed tomography (CT) which has a high sensitivity and specificity (5).…”

Section: Introductionmentioning

confidence: 99%

Evaluation of renal function with renography in patients with renal colic

Gharepapagh,

Hassanzadeh,

Ghabousian

et al. 2023

FEM

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Objective: Urolithiasis is responsible for the majority of urological emergencies. Although computed tomography (CT) scan can identify urinary obstruction caused by stones, there is a growing concern about exposure to radiation made by this method. Renal scintigraphy can provide valuable insights regarding the functional status of kidneys and can significantly reduce exposure to radiation. The goal of present study was to assess renal function through renal scintigraphy in patients with acute renal colic and it explores the association between renal scintigraphy performance and ultrasound in terms of detecting hydronephrosis. Methods: For this study, 20 patients with acute renal colic were chosen. Each patient underwent renal ultrasonography and subsequently received renal scintigraphy with Technetium-99m diethylenetriaminepentaacetic acid (Tc-99m DTPA). Cohen's Kappa coefficient and Cramer's V correlation were employed to demonstrate the extent of agreement between ultrasound and renal scintigraphy. Results: 12 (60%) patients were male. Glomerular filtration rate (GFR) values were correlated with Cockcroft-Gault equation and the Gates method (P=0.002, r=0.642). There was a good agreement and a statistically significant relationship between ultrasound and renal scintigraphy in terms of detecting obstructive uropathy in both kidneys. Conclusion: To conclude, GFR values were correlated between Cockcroft-Gault equation and the Gates method in patients with acute renal colic. There was a good agreement and statistically significant relationship between ultrasound and obstructive renography results in both kidneys. However, we found no association between perfusion phase of renal scintigraphy and ultrasonography in terms of hydronephrosis detection.

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ACR Appropriateness Criteria® Radiologic Management of Urinary Tract Obstruction

Cited by 2 publications

References 83 publications

Relieving urinary tract obstructions may increase the risk of gouty arthritis in patients with hyperuricemia and postrenal obstructions

Relieving urinary tract obstructions may increase the risk of gouty arthritis in patients with hyperuricemia and postrenal obstructions

Evaluation of renal function with renography in patients with renal colic

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