Factors Influencing the Non-recovery of Renal Function After the Relief of Urinary Tract Obstruction in Women with Cancer of Cervix

Lutaif, Nelson Afonso; Yu, Liang; Abdulkader, Regina C. R. M.

doi:10.1081/jdi-120018722

Cited by 14 publications

(11 citation statements)

References 22 publications

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“…The complete renal recovery at 30 th day after diversion improves patient survival despite malignancy. [7] Our patient also had a normal creatinine at one month. Ishioka et al .…”

Section: Discussionmentioning

confidence: 59%

Aggressive approach in a case of cancer cervix with uremia

Janaki

Mukesh

Ponni

et al. 2010

Indian J Palliat Care

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Carcinoma of cervix is the most common cancer in developing countries. Majority of them present in locally advanced stages. A 36-year-old lady presented with bleeding and white discharge per vagina since four months, vomiting and reduced urine output since two weeks. Patient had an exophytic cervical growth. Investigation revealed elevated serum creatinine. Patient received single fraction radiation and underwent percutaneous nephrostomy. At one month follow-up, serum creatinine returned to almost normal level. Patient underwent bilateral ante grade stenting and completed concurrent chemoradiotherapy. In selected subsets of patients, aggressive management offered longer palliation and good quality of life.

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“…The complete renal recovery at 30 th day after diversion improves patient survival despite malignancy. [7] Our patient also had a normal creatinine at one month. Ishioka et al .…”

Section: Discussionmentioning

confidence: 59%

Aggressive approach in a case of cancer cervix with uremia

Janaki

Mukesh

Ponni

et al. 2010

Indian J Palliat Care

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“…The reversibility of renal function is associ ated with better preservation in children than in adults, which is related to several factors, such as incomplete and shortduration obstruction 3) . Diffuse and severe tubular atrophy with interstitial fibrosis in renal biopsy were indi cated in adults with malignant ureteral obstruction 12) . These histologic findings may be aggravated in proportion to the obstruction period, thus, affecting the renal prog nosis.…”

Section: Discussionmentioning

confidence: 97%

“…The average life expectancy was less than 1 year 7) . Furthermore, a renal function re covery rate of 42-44% was reported after the resolution of malignant ureteral obstruction 11,12) . However, the overall survival rate of children with malignant ureteral obstruc tion was approximately 70%, indicating that the prognosis of children was better than that of adults 3,13) .…”

Section: Discussionmentioning

confidence: 99%

Bilateral Ureteral Obstruction Related to Pelvic Rhabdomyosarcoma Presenting with Acute Kidney Injury: A Case Report

Han¹,

Han²

2019

Child Kidney Dis

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Bilateral renal obstruction is a rare critical condition, requiring a prompt diagnostic approach and treatment to restore the renal function. The most commonly observed obstructive uropathy in children is congenital malformation, such as posterior urethral valves and bilateral ureteropelvic junction obstruction. Malignant pelvic masses obstructing the ureter are widely reported in adults but are rarely observed in children. The treatment of ureteral obstruction related to pelvic malignancy is a therapeutic challenge with a median survival duration of 3-7 months in adults; however, pediatric patients with pelvic malignancy leading to ureteral obstruction had better outcomes, with a reported 5-year mortality rate of 20%, than the adult patients. Here, we report a rare case of bilateral ureteral obstruction associated with pelvic rhabdomyosarcoma presenting with acute kidney injury treated by ureteral diversion with double J stent, and concommittent emergency hemodialysis, leading to restoration of good renal function. We suggest that bilateral ureteral obstruction should be released as soon as possible using surgical or interventional approach to minimize the obstruction period, and subsequential chemotherapy may contribute to improvement of survival and recovery of renal function.

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“…Prognozuojant inkstø funkcijos normalizavimosi efektyvumà po drenaþo procedûrø ir planuojant papildomà terapijà, labai svarbi informacija apie klinikiniø ir morfologiniø veiksniø átakà inkstø funkcijos atsitaisymui. Ávairûs tyrëjai prieþastis, kodël nepavyksta sëkmingai atkurti inkstø funkcijos drenavus virðutinius ðlapimo takus, sieja su vyresniu amþiumi ir plonesne parenchima [6]. Ðiame darbe irgi pastebëta priklausomybë tarp parenchimos storio ir kreatinino maþëjimo per parà rodiklio.…”

Section: Diskusijaunclassified

“…Analizuojant ûminá obstrukciná inkstø nepakankamumà paaiðkëjo, kad obstrukcijos dël akmenligës atvejais inkstø funkcija atsitaisë 69,5% pacientø [8]. Aiðkinantis inkstø funkcijos normalizavimosi nesëkmes, atliktos inkstø biopsijos, rasta intersticinë fibrozë, þidininë glomerulosklerozë, ir tai galima sieti su minëtomis nesëkmëmis [6]. Lëtai progresuojanèios obstrukcijos patogenezëje, manyt, svarbus vaidmuo tenka inkstø struktûros pokyèiams, kurie lemia neveiksmingà drenaþà.…”

Section: Diskusijaunclassified

Viršutinių šlapimo takų obstrukcijos sukelto inkstų funkcijos pažeidimo gydymas drenuojant viršutinius šlapimo takus

Ramonas¹

2005

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Henrikas RamonasVilniaus universiteto Gastroenterologijos,nefrologijos, urologijos ir pilvo chirurgijos klinika,Vilniaus universiteto ligoninės Santariškių klinikosNefrologijos ir urologijos centras,I Nefrourologijos skyrius,Santariškių g. 2, LT-08661 VilniusEl paštas: henrikas.ramonas@santa.lt Įvadas / tikslas Šiame darbe siekiama nustatyti šlapimo takų pokyčių reikšmę inkstų funkcijos atsitaisymui, drenavus viršutinius šlapimo takus dėl jų obstrukcijos ir ryškaus inkstų pažeidimo. Tai padėtų planuoti optimalų gydymą po drenavimo. Ligoniai ir metodai Retrospektyviai išanalizuota 60 ligonių, kuriems 1999–2004 metais drenuoti viršutiniai šlapimo takai dėl obstrukcijos ir koreguota ryškiai pažeista inkstų funkcija. Statistinės analizės būdu nustatyta ikioperacinių šlapimo takų funkcinių ir morfologinių pokyčių įtaka inkstų funkcijos atsitaisymui po drenuojamųjų operacijų. Rezultatai Vidutinis ligonių amžius – 66,38 ± 1,54 metų. Nuo abiejų inkstų obstrukcijos gydyti 35 (58,33%), nuo vienintelio funkcionuojančio inksto – 25 (41,67%) ligoniai. Perkutaninė nefrostomija atlikta 48 (80,0%), operacinė nefrostomija – 5 (8,33%), šlapimtakių stentavimas – 7 (11,67%) ligoniams. Paliatyvus inkstų drenavimas atliktas 31 (51,67%) ligoniui. Pacientams, kuriems kliniškai nustatyta greita obstrukcijos eiga, vidutinė kreatinino koncentracija po gydymo daug geresnė, palyginti su lėtinės obstrukcijos atvejais, – atitinkamai 240,48 ± 25,7 µmol/l ir 395,83 ± 22,3 µmol/l (p < 0,05). Iš morfologinių parametrų geriausiai koreliuoja vidutinis inkstų parenchimos storis ir pooperacinis kasdienis kreatinino mažėjimo rodiklis, ypač pacientų, sergančių inkstų akmenlige (r = 0,55). Diagnozavus abipusę obstrukciją 31 onkologiniam ligoniui, vienpusė nefrostomija buvo pakankama koreguojant inkstų funkciją 27 (87,1%) ligoniams. Išvados Viršutinių šlapimo takų drenažas dėl obstrukcijos ir inkstų funkcijos pažeidimo visais atvejais šią funkciją pagerino. Greičiau ji atsitaiso ligonių, kuriems kliniškai nustatyta greita obstrukcijos eiga ir kuriems iki drenažo rasta storesnė parenchima. Vienpusis paliatyvus viršutinių šlapimo takų drenažas pagerino inkstų funkciją 87% ligonių. Reikšminiai žodžiai: obstrukcinė uropatija, inkstų nepakankamumas, nefrostomija Treatment of renal impairment in patients with obstructive upper urinary tract by draining procedures Henrikas RamonasVilnius University, Clinic of Gastroenterology,Urology and Abdominal Surgery,Center of Nephrology and Urology,Vilnius University Hospital "Santariškių klinikos",Santariškių str. 2, LT-08661 Vilnius, LithuaniaE-mail: henrikas.ramonas@santa.lt Background / objective To evaluate the influence of urinary tract changes on renal functional recovery when drainage of the upper urinary tract is performed in the case of ureteric obstruction and severe renal impairment, looking for options of more optimal postoperative therapy. Patients and methods In 60 consecutive patients with upper urinary tract obstruction and severe renal impairment, treated in the urological department from 1999 until 2004, a retrospective analysis of treatment cases was done. Statistical analysis of preoperative functional and morphological changes of the urinary tract, evaluation of their influence on postoperative renal functional recovery was done. Results The patients’ age was 66.38 ± 1.54 years. Bilateral obstruction was found in 35 (58.33%), solitary kidney obstruction in 25 (41.67%) patients. Percutaneous nephrostomy was performed in 48 (80.0%), operative nephrostomy in 5 (8.33%), ureteric stenting in 7 (11.67%) cases. Palliative kidney drainage was employed for 31 (51,67%) patients. In the patients in whom obstruction development was clinically defined as rapid, the mean plasma creatinine concentration after treatment was lower in comparison with chronic obstruction, reaching respectively 240.48 ± 25.7 µmol/l and 395.83 ± 22.3 µmol/l (p < 0.05). A positive correlation was found among renal cortical thickness and daily postoperative creatinine level decrease, especially in cases of nephrolithiasis (r = 0.55). When bilateral obstruction was diagnosed in 31 oncological patients, unilateral nephrostomy was a sufficient treatment option in 27 (87.1%) cases. Conclusions Drainage of the obstructed upper urinary tract influences renal functional recovery in all cases. In clinically defined rapid obstruction cases, renal functional recovery is better in comparison with chronic obstruction. Renal functional recovery postively corellated with renal cortical thickness. Unilateral nephrostomy was a sufficient treatment option in the palliative obstructive treatment course in 87% of patients. Keywords: obstructive uropathy, renal failure, nephrostomy

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Factors Influencing the Non-recovery of Renal Function After the Relief of Urinary Tract Obstruction in Women with Cancer of Cervix

Abstract: The non-recovery of renal function after the relief of obstruction in human obstructive renal failure is associated with older age and decreased renal cortical thickness. The complete renal recovery improves patient survival despite malignancy.

Cited by 14 publications

References 22 publications

Aggressive approach in a case of cancer cervix with uremia

Aggressive approach in a case of cancer cervix with uremia

Bilateral Ureteral Obstruction Related to Pelvic Rhabdomyosarcoma Presenting with Acute Kidney Injury: A Case Report

Viršutinių šlapimo takų obstrukcijos sukelto inkstų funkcijos pažeidimo gydymas drenuojant viršutinius šlapimo takus

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