Efficacy of medical treatment of schistosomal obstructive uropathy as determined by 131I-Hippuran renography

Young, Stuart W.; Farid, Z.; Bassily, S.; Masry, N.A. El

doi:10.1016/0035-9203(78)90017-2

Cited by 4 publications

(1 citation statement)

References 9 publications

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“…The etiological factors contributing to obstructive uropathy vary significantly with age and gender, with children often affected by conditions such as pelvi-ureteric junction obstruction and posterior urethral valves, whereas adults face urolithiasis, and older individuals are at risk from malignancies and abnormalities related to the prostate, urethra, or gynecological issues (8,9). The sequelae of untreated obstructive uropathy are profound, including alterations in blood homeostasis, severe anemia, electrolyte imbalances, sepsis, and a decrease in glomerular filtration rate, which may culminate in acute renal failure, renal fibrosis, chronic renal failure, and ultimately, patient mortality (9,10). The advent of advanced imaging techniques and minimally invasive procedures has revolutionized the diagnostic and therapeutic landscape for obstructive uropathy, offering earlier detection and improved management strategies (11,12).…”

Section: Introductionmentioning

confidence: 99%

Comparison Efficacy between Percutaneous Nephrostomy and Double J Stent in Management of Obstructive Uropathy

Khan,

Kumar,

Bux

et al. 2024

JHRR

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Background: The prevalence of urolithiasis and associated acute kidney injury (AKI) has seen a notable increase in recent decades, particularly in developing countries such as Pakistan, which falls within the "stone forming belt" region. This rise has underscored the need for effective management strategies for obstructive uropathy, a potentially reversible condition if timely intervention is provided. However, the literature reveals a divergence in treatment approaches between different regions and among healthcare professionals, with no universally recommended treatment for relieving the obstructed system. Objective: This study aimed to evaluate and compare the efficacy of percutaneous nephrostomy (PCN) versus Double J stent (DJS) in the management of obstructive uropathy secondary to urolithiasis in patients with elevated serum creatinine levels. Methods: Conducted as a randomized controlled trial at the Jinnah Postgraduate Medical Center Karachi from January 2023 to December 2023, the study included patients aged 20 to 50 years with obstructive uropathy secondary to urolithiasis and serum creatinine above or equal to 2.0 mg/dL. Exclusion criteria encompassed obstructive uropathy due to bladder outlet obstruction, uncontrolled coagulopathy, and lack of consent. Participants were randomized into two groups for either PCN or DJS placement, with pre-operative and post-procedure serum creatinine and urea levels measured at multiple intervals. Data analysis was performed using SPSS version 25. Results: The study enrolled 30 patients in the PCN group and 30 in the DJS group. Efficacy rates for PCN and DJS were 93.3% (28 out of 30) and 76.7% (23 out of 30), respectively. Stratified analysis revealed no statistically significant differences in efficacy based on age, gender, or duration of illness, although a trend favoring PCN was observed in patients over 40 years and those treated within 5-10 days of illness onset. Conclusion: While both PCN and DJS are effective interventions for obstructive uropathy secondary to urolithiasis, PCN showed a non-significantly higher overall efficacy. These findings suggest a potential preference for PCN in certain patient subsets, though further research with larger sample sizes and multi-center trials is needed to substantiate these observations.

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Section: Introductionmentioning

confidence: 99%

Comparison Efficacy between Percutaneous Nephrostomy and Double J Stent in Management of Obstructive Uropathy

Khan,

Kumar,

Bux

et al. 2024

JHRR

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Isotope renography and urinary schistosomiasis: a study in a Gambian community

Wilkins

Amuasi

Crawley

et al. 1985

Transactions of the Royal Society of Tropical Medicine and Hygi

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A transportable apparatus for isotope renography, which allowed deconvolution analysis, was used to study the prevalence and prognosis of abnormalities associated with urinary schistosomiasis. Before carrying out studies in a heavily infected community, observations were made in a non-endemic area to allow derivation of criteria for abnormality. Comparison of the findings in the two areas showed that changes suggesting urinary tract obstruction were more common in the endemic area in subjects between nine and 45 years but not in older subjects. Measurements of effective renal plasma flow showed renal function was impaired in the endemic area in subjects older than 17 years but not in younger subjects. In the endemic area the results of renography were unrelated to the urinary egg count of the subjects examined, but there was an improvement in the abnormal renograms in a group of subjects aged between nine and 20 years who were re-examined a year after treatment with metrifonate. Follow-up data about 316 subjects was obtained two years after renography. Nine subjects had died, including four of the five subjects with abnormalities suggesting both obstruction and over-all loss of renal function. These findings, which are comparable to the results of similar studies using radiological techniques, suggest urinary schistosomiasis may be a significant cause of mortality in adults in intensely infected communities.

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