Risk factors for developing a perirenal hematoma after flexible ureteroscopic lithotripsy

Kao, Ming-Wei; Wang, Chung‐Cheng

doi:10.1016/j.urols.2015.09.003

Cited by 12 publications

(3 citation statements)

References 16 publications

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“…6 Chronic kidney disease (CKD) was suggested by Kao et al as a predisposing factor for perirenal haemorrhage, as such kidneys might be structurally weaker and more easily damaged than their healthy counterparts. 7 Other risk factors described in a systematic review included moderate to severe hydronephrosis, thinner renal cortex, presence of urinary tract infection and hypertension. 5 In our patient, the factors that could have contributed to the massive retroperitoneal bleeding included: (a) native ESKD kidneys, which were more fragile and predisposed to bleeding from minor trauma or raised intrarenal pressure during RPG; (b) small-calibre upper urinary tracts, requiring a greater syringe pressure to push the intraluminal contrast up into the kidneys; and (c) use of clopidogrel, although the risk of persistent platelet dysfunction was low after 7 days of discontinuation.…”

Section: Discussionmentioning

confidence: 99%

Massive retroperitoneal haemorrhage after retrograde pyelogram in end-stage kidneys: A case report

Yang

Gan

et al. 2020

Proceedings of Singapore Healthcare

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Severe retroperitoneal haemorrhage after retrograde pyelogram (RPG) is rare and has not been reported in the literature. One of the few indications for performing RPG in end-stage kidneys is evaluation of the upper urinary tract for malignancy. We present a rare case of massive retroperitoneal haemorrhage in a 58-year-old man, with a history of deceased donor kidney transplantation for end-stage kidney disease (ESKD), following bilateral RPG for the evaluation of urothelial cancer. The bleeding was successfully stopped with renal artery angioembolisation. This case demonstrates the importance of exercising extra caution when performing endoscopic procedures in patients with ESKD and keeping the intrarenal pressure as low as possible.

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Section: Discussionmentioning

confidence: 99%

Massive retroperitoneal haemorrhage after retrograde pyelogram in end-stage kidneys: A case report

Yang

Gan

et al. 2020

Proceedings of Singapore Healthcare

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“…Surgery is only performed on patients who are hemodynamically unstable. Kao, 2015 12 Taiwan Retrospective observational study…”

Section: Indiamentioning

confidence: 99%

Perirenal Hematoma After Ureteroscopy : A Systematic Review

Rachmadhyan¹

2023

JARMHS

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The global incidence of urolithiasis is 14%, and the burden of urological consultants has increased by 20% over the past seven years, according to current trends. As a consequence, stone disease is becoming a burden on our health care system. However, advancements in apparatus and technology over the past two decades have made it possible for endourologists to perform increasingly complex treatments for the management of stones. Endourologists who treat ureteral or renal calculi are required to be aware of PRH risk factors. PRH occurred more frequently among patients with a low BMI. Patients with a low BMI had less body fat and perirenal fat than those with a higher BMI. After an injury, perirenal fat cushions the kidney to prevent cortical overstretching caused by an increase in renal pelvis irrigation pressure. PRH is produced in kidneys with minimal perirenal adipose. Two of the four patients with PRH had a low BMI. Underweight can be a sign of malnutrition, which can impair the structure of the kidneys. The timing of surgery is uncertain. PRH caused by FURSL may be treated as a kidney injury. If the patient has loin or flank pain after FURSL, the surgeon should examine the serum hemoglobin and perform abdominal sonography or a CT scan to detect PRH. Hematomas with mass effect were evacuated percutaneously when they were large. Percutaneous drainage may delay the progression of a hematoma in stable patients, although it may cause severe discomfort or renal compression. Angiograms should be used to treat renal bleeding if the serum hemoglobin continues to decline. If conservative or angiographic therapy fails to control bleeding, immediate open surgery must be performed. Cases of PRH are extremely uncommon, with percentages ranging from 0.1 to 8.9%. Despite this, this condition needs to be monitored closely because it has the potential to compromise the patient's health in a negative way.

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“…These therapeutic techniques have brought the urolithiasis surgical treatment into the era of minimally invasive. However, there are still some serious surgical complications, such as ureteric sepsis, perinephric hematoma, and mucosal detachment of ureter [5][6] . Therefore, it is crucial for us to prevent the occurrence of urinary stones.…”

Section: Introductionmentioning

confidence: 99%

Association between Metabolic Syndrome and the Risk of Nephrolithiasis: A Cohort Study

Sun,

Wang,

Wang

2024

Preprint

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Objectives: Kidney stones are a common urological disease with increasing incidence in numerous countries every year, and its risk factors and prevention are significant public health issues. This study examined the association of metabolic syndrome with incident kidney stones. Methods: This study included 36 811 adults from the health checkup population (2018–2023). The Cox proportional hazards model was used to elucidate the relationship between metabolic syndrome, the number of metabolic components, metabolic syndrome components, and the risk of nephrolithiasis. This essay used stratified analyses to identify participants with higher incidence risk. Results: During 93 965.97 person-years of follow-up, 573 participants developed nephrolithiasis. Participants with metabolic syndrome had a higher risk of nephrolithiasis than those without metabolic syndrome. Increasing odds of nephrolithiasis with increasing number of metabolic syndrometraits. Obesity and hypertension were significantly associated with the risk of nephrolithiasis. However, we did not find that it was nonlinearly associated with higher risks of nephrolithiasis among participants with obesity, hypertension, hyperglycemia, and dyslipidemia. Compared with participants without metabolic syndrome, those with metabolic syndrome had a 60.5% higher risk of nephrolithiasis (hazard ratio 1.605, 95% confidence interval 1.275,2.021). Metabolic syndrome, number of metabolic components, and metabolic syndrome composition were independent risk factors for kidney stones in males, whereas these variables were not associated with kidney stones in females. Conclusions: Metabolic syndrome, the number of metabolic components, obesity, and hypertension were positively associated with increased risk for nephrolithiasis, which were only observed among men.

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Risk factors for developing a perirenal hematoma after flexible ureteroscopic lithotripsy

Cited by 12 publications

References 16 publications

Massive retroperitoneal haemorrhage after retrograde pyelogram in end-stage kidneys: A case report

Massive retroperitoneal haemorrhage after retrograde pyelogram in end-stage kidneys: A case report

Perirenal Hematoma After Ureteroscopy : A Systematic Review

Association between Metabolic Syndrome and the Risk of Nephrolithiasis: A Cohort Study

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