Improved Split Renal Function after Percutaneous Nephrostomy in Young Adults with Severe Hydronephrosis Due to Ureteropelvic Junction Obstruction

Zhang, Shiwei; Zhang, Qing; Ji, Changwei; Zhao, Xiaozhi; Liu, Guangxiang; Zhang, Shun; Li, Xiaogong; Lian, Huibo; Zhang, Gutian; Guo, Hongqian

doi:10.1016/j.juro.2014.07.005

Cited by 18 publications

(25 citation statements)

References 16 publications

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“…Radionuclide renography is the most commonly used method, but it is difficult to evaluate the outcomes at different follow-up times using this technique [12,13]. A PCN catheter should remain inserted for about 4-12 weeks [1], but patients with PCN drainage are at increased risk of further renal function loss and infection [4,11]. Transforming growth factor-β and urinary tubular enzymes have also been used to predict the recoverability of renal function after the relief from obstruction, though the efficacy and feasibility of these biological agents need further evaluation [14,15].…”

Section: Discussionmentioning

confidence: 99%

“…However, the kidneys in children are still developing, allowing the potential for renal function to recover after removal of obstruction in children, even in the case of severe obstruction [18]. It is usually diagnosed early because of its obvious symptoms, and is thus often mild when diagnosed, and the potential recoverability of renal function in adults is therefore also often favorable [1,10,13]. However, Zhang et al [1] found that age still played an important role in postoperative improvement of renal function, even among adult patients.…”

Section: Discussionmentioning

confidence: 99%

“…The predictive values of the above parameters in terms of recoverability of renal function were evaluated. The patients were divided into two groups according to the improvement of DRF detected by the renography: an improvement group including patients with a >10% increase [1] in DRF over the basal value, and a non-improvement group with an increase of <10% over the basal value.…”

Section: Methodsmentioning

confidence: 99%

“…Congenital ureteropelvic junction obstruction (UPJO) is the most common cause of hydronephrosis [1], which impairs renal function and eventually leads to renal parenchymal atrophy [2]. Hydronephrosis in infants and children is often associated with a short disease duration and only mildly impaired renal function.…”

Section: Introductionmentioning

confidence: 99%

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Predictors of Recoverability of Renal Function after Pyeloplasty in Adults with Ureteropelvic Junction Obstruction

Wu¹,

Wei²,

Chen³

et al. 2018

Urol Int

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Background: This study aimed to identify factors predicting the recoverability of renal function after pyeloplasty in adult patients with ureteropelvic junction obstruction. Methods: We retrospectively reviewed 138 adults with unilateral renal obstruction-induced hydronephrosis and who underwent Anderson-Hynes dismembered pyeloplasty from January 2013 to January 2016. Hydronephrosis was classified preoperatively according to the Society for Fetal Urology (SFU) grading system. All patients underwent Doppler ultrasonography, excretory urography, computed tomography, and technetium-99m-diethylenetriamine pentaacetic acid radioisotope (99mTc DTPA) renography before and after surgery. Renal resistive index (RRI) and 99mTc DTPA renography were repeated at 1, 3, 6, and 12 months. Results: Multivariate analysis identified age, renal pelvic type, SFU grade, preoperative RRI, decline of RRI, and renal parenchyma to hydronephrosis area ratio (PHAR) as independent predictors of renal function recoverability after pyeloplasty. However, preoperative RRI and RRI decline were not significantly associated with recoverability of renal function in patients aged >35 years. Lower preoperative RRI, greater decline in RRI, higher PHAR, lower SFU grade, and extrarenal pelvis were associated with greater improvements in postoperative renal function. Conclusions: Preoperative differential renal function cannot independently predict the recoverability of postoperative renal function in adult patients with unilateral renal obstruction-induced hydronephrosis. SFU grade, renal pelvic type, PHAR, preoperative RRI, and decline in RRI were significantly associated with the recoverability of renal function in adult patients aged <35 years, while only SFU grade, renal pelvic type, and PHAR were significantly associated with renal function recoverability in patients aged ≥35 years. Renal function recovery was better in patients younger than 35 years when compared with older patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Predictors of Recoverability of Renal Function after Pyeloplasty in Adults with Ureteropelvic Junction Obstruction

Wu¹,

Wei²,

Chen³

et al. 2018

Urol Int

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“…üreteropelvik darlığa bağlı ciddi hidronefrozu ve bölünmüş renal fonksiyonu %10'un altın-da olan 53 hastaya PKN takmışlar ve 29 genç erişkinin 24'ünde (%82.8) bölünmüş böbrek fonksiyonlarında düzelme görmüşler [1]. Diğer taraftan toplayıcı sistem dışına idrar kaçağı ile birlikte olan non-obstrüktif üropatiler enfekte ürinom, retroperitoneal abse, pyelonefrit, peritonit ve ürosepsis gibi ciddi komplikasyonlara yol açabilir [1]. PKN bu durumların hepsinde hem ağrının giderilmesi hem de enfeksiyonun önlenmesi için ideal girişimdir.…”

Section: Introductionunclassified

Urologist Directed Percutaneous Nephrostomy Tube Placement: 6 Years Experience

2016

Ann Clin Anal Med

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ÖzetAmaç: Kliniğimizde 6 yıl süresince perkütan nefrostomi (PKN) uygulamaları-mızı ve komplikasyonlarımızı modifiye Clavien sınıflamasına göre raporlamayı amaçladık. Gereç ve Yöntem: Kliniğimizde 722 hastaya (538 erkek ve 184 kadın) 814 PKN uygulandı. PKN uygulaması dilate sistemlerde ultrason eşli-ğinde, dilate olmayan sistemlerde ise ultrason/fluroskopi eşliğinde yapıldı.Kateterden spontan idrar gelişi başarılı olarak kabul edildi. Komplikasyon sayı-ları tescil edildi. Bulgular: PKN takılan 814 sistemin 770'inde (94.5%) başa-rı sağlanmıştır. Dilate olmayan ve dilate sistemler için başarı oranlarımız sı-rasıyla % 71.1, % 97.7 ve toplam komplikasyon oranımız %17.3 idi. Modifiye Clavien sınıflamasına göre komplikasyonlarımız derece I, II, III, IV ve V için sırasıyla % 9, % 1.2, % 6.2, % 0.3, % 0.3, % 0.4 ve % 0.1idi. Hasta yaşı, hidronefroz derecesi, serum kreatinin seviyesi ve ortalama hemoglobin düzeyi komplikasyon gelişimi açısından anlamlı risk faktörleri olarak saptandı. Ayrı-ca dilate olmayan sistemin komplikasyon oranlarını anlamlı şekilde etkilediği görüldü. Tartışma: Perkütan nefrostomi obstrüksiyona bağlı dilate sistemlerin geçici ve kalıcı tedavisinde iyi bilinen bir yöntemdir. Uygulamalara bağlı komplikasyonların tanımlanması klinik karşılaştırmaların çok daha doğru yapılması için çok önemlidir. . Modifiye Clavien sınıflaması PKN komplikasyonlarının değerlendirilmesi için kullanılabilir bir sistemdir. Anahtar KelimelerPerkütan Nefrostomi; Sonuçlar; Clavien; Komplikasyonlar Abstract Aim: To report our results on percutaneous nephrostomy (PCN) and classify our complications with the modified Clavien Classification System (CCS) in 6 years. Material and Method: Eight hundred fourteen PCN insertions were performed in 722 patients (538 men and 184 women) at our institution. PCN insertion was performed under ultrasound for dilated pelvicalyceal system and ultrasound/fluoroscopy for nondilated system. PCN was considered successful if the catheter was drained urine spontaneously. Number of complications was registered. Results: Primary successful PCN insertion was achieved in 770 of the 814 procedures (94.5%). The success rates for nondilated and dilated systems were 71.1% and 97.7%, respectively. Our overall complication rate was 17.3%. According to the modified CCS grades I, II, III, IV, and V were 9%, 1.2%, 6.2%, 0.3%, 0.3%, 0.4% and 0.1%, respectively. Age, grade of the hydronephrosis, serum creatinine levels, and mean hemoglobin levels were statistically significant parameters for the occurrence of complications. The nondilated system has statistically significant parameter affecting the complication rates. Discussion: Percutaneous nephrostomy is a well-known procedure in the treatment of temporary or permanent drainage of an obstructed system. It is very important to define the complications related to interventions for interpretation of clinical comparisons more accurately. Modified CCS is a reproducible system to evaluate the complications of PCN.

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Utilizing computed tomography-based renal parenchymal volumes to calculate split renal function in patients with ureteral stricture disease

Ji,

Arteaga,

Raikar

et al. 2024

World J Urol

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Improved Split Renal Function after Percutaneous Nephrostomy in Young Adults with Severe Hydronephrosis Due to Ureteropelvic Junction Obstruction

Cited by 18 publications

References 16 publications

Predictors of Recoverability of Renal Function after Pyeloplasty in Adults with Ureteropelvic Junction Obstruction

Predictors of Recoverability of Renal Function after Pyeloplasty in Adults with Ureteropelvic Junction Obstruction

Urologist Directed Percutaneous Nephrostomy Tube Placement: 6 Years Experience

Utilizing computed tomography-based renal parenchymal volumes to calculate split renal function in patients with ureteral stricture disease

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