Is Renal Biopsy a Better Predictor of the Outcome of Pyeloplasty in Adult Ureteropelvic Junction Obstruction?

Evaluation of Factors Predicting Recoverability of Renal Function after Pyeloplasty in Adults

“…Most recently, Wu et al [4] have retrospectively examined 85 adult patients who had unilateral renal obstruction and concluded that DRF did not improve after relief of renal obstruction. Similarly, Bhat et al [2] have prospectively followed up 24 adult patients who underwent pyeloplasty and reported 6 patients (out of 11 with preoperative DRF ≤30%) and 4 (out of 13 with preoperative DRF >30%) who had improved DRF at the 1-year follow-up (p = 0.87) and that the DRF remained stable at the 3-year follow-up. Similar results were addressed by Ortapamuk et al [14].…”

“…Although postoperative diuretic scintigraphy has been performed at a median follow-up of 11 months, not all patients underwent scintigraphy at the same intervals. Nevertheless, previous reports have suggested a static renal function during the follow-up period [2]. …”

“…Nevertheless, many points should be explained. First, the definition of preoperative DRF that would predict the outcome is different among studies and there are different cut-off values for DRF in the literature [2,4]. Second, previous publications have had a relatively low number of patients to draw any firm conclusions from [2,14].…”

“…However, our report has several limitations in that it is retrospective and, in addition, we estimated the recoverability of renal function based on diuretic scintigraphy whose accuracy has been questioned [2,9]. Although postoperative diuretic scintigraphy has been performed at a median follow-up of 11 months, not all patients underwent scintigraphy at the same intervals.…”

“…Ureteropelvic junction obstruction (UPJO) is a common cause of chronic unilateral renal obstruction and the aim of management is to prevent deterioration of renal function and to alleviate symptoms [1,2]. Reports in the literature have suggested that differential renal function (DRF) is less likely to improve after relief of obstruction [3,4], and those with a lower preoperative renal function were most likely to have more improvement of function [4,5].…”