Epidemiological, Clinical and Therapeutic Profile of Obstructive Renal Failure

Abstract

Aim: To describe the epidemiological, clinical, etiologic and therapeutic aspects of patients with acute obstructive renal failure at the Medical Surgical Center of Urology (MSCU). Materials and methods: this was a descriptive retrospective study of 106 patient records treated for acute renal failure from January 2012 to December 2016. Patients came for spontaneous consultation or were referred. They had benefited from a clinical and paraclinical assessment at the end of which the diagnosis of acute renal failure was retained and then an effective management at the MSCU. The variables studies were clinical, paraclinical, therapeutic and progressive. The treatment included: hemodialysis, urinary diversion (suprapubic, urethrovesical and ureteral), trans-urethral resection of the prostate, trans-urethral resection of the bladder, nephrostomy, endoscopic incision of catheter valves, posterior urethra or laparoscopic nephroureterectomy as indicated. The emergency treatments consisted of removing the obstacle and the etiological treatment was done later. External follow-up consultation varied by etiology. Results: In 4 years we had treated 106 patients, a frequency of 26.5%. The average age was 47.83 years with extreme of 2 and 80 years old. The sex ratio was 68 men for 38 women. The mean serum creatinine level was 37.8 mg/l (335 µmol/l). The etiologies were: prostatic pathologies (n = 38), lithiasic pathologies (n = 20) and gynecological pathologies (n = 18). The treatments were: endoscopic resection of prostate (n = 24), bladder (n = 6), posterior urethral valves (n = 4), JJ probe (n = 27) and nephrostomy (n = 23). The result was good (normalization of creatinine serum) in 79 patients, the persistence of elevated serum creatinine was observed in 4 patients and 18 patients died. Conclusion: Acute obstructive renal failure is a common diagnosis in our exercise setting at MSCU where it can be managed with respect to our technical platform.