Evaluating Ultrasound-Guided Percutaneous Nephrostomy in Low-Resource Settings: Insights from Northern Nigeria

Abstract

Objectives: Percutaneous Nephrostomy (PCN) is a procedure that decompresses or provides access to the renal collecting system. There is a dearth of data about the complications and outcomes of PCN in low and middle-income countries. Objectives: This audit will provide insight into the complications and outcomes of PCN in Nigeria. Methods: This prospective study was on fifty-five patients who had PCN under ultrasound guidance. We obtained pre-PCN and serial serum creatinine on day one, one week, and one month post-PCN. The patients were monitored for two weeks. We also documented whether or not, the patient has continued to be on dialysis or died. The categorical data was expressed as proportions and percentages. The student’s t-test to compare means between groups for continuous variables. A p-value of <0.05 was considered statistically significant. Results: Up to 32 (58.2%) were males. About 80% of patients had bilateral PCN. Some patients (27.2%) developed minor complications such as pain, wire impaction, bleeding, or vomiting. During the late post-procedure and follow-up periods, 72.7% had no complication, 12.7% had dislodged tube(s), 10.9% had unilateral tube blockage, and 1.8% had bilateral tube blockage. The study also showed a significant reduction of serum creatinine in 80% of the subjects. 12.7% of the patients died with 5.5% of patients lost to follow-up, and 1.8% had fluctuating creatinine levels. Conclusion: Ultrasound-guided PCN is a safe procedure to relieve obstructive uropathy in our setting. PCN significantly improves patient outcomes when performed judiciously and in inappropriate clinical contexts.