Serum Creatinine Predicts Success in Retrograde Ureteral Stent Placement in Patients with Pelvic Malignancies

McCullough, T. Casey; May, Noah R.; Metro, Michael J.; Ginsberg, Phillip C.; Jaffe, Jamison S.; Harkaway, Richard C.

doi:10.1016/j.urology.2007.12.068

Cited by 14 publications

(12 citation statements)

References 15 publications

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“…In 2007, three retrospective studies were reviewed with various numbers of patients[ 21 - 23 ]. However, five retrospective studies were found in 2008 and 2009[ 24 - 28 ], and three of them had comparative designs[ 25 , 27 , 28 ]. In 2010, the first prospective study was published within the time frame of this review[ 29 ].…”

Section: Description Of Summarized Literaturementioning

confidence: 99%

Acute kidney injury due to bilateral malignant ureteral obstruction: Is there an optimal mode of drainage?

Gadelkareem¹,

Abdelraouf²,

El-Taher³

et al. 2022

World J Nephrol

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There is a well-known relationship between malignancy and impairment of kidney functions, either in the form of acute kidney injury or chronic kidney disease. In the former, however, bilateral malignant ureteral obstruction is a surgically correctable factor of this complex pathology. It warrants urgent drainage of the kidneys in emergency settings. However, there are multiple controversies and debates about the optimal mode of drainage of the bilaterally obstructed kidneys in these patients. This review addressed most of the concerns and provided a comprehensive presentation of this topic from the recent literature. Also, we provided different perspectives on the management of the bilateral obstructed kidneys due to malignancy. Despite the frequent trials for improving the success rates and functions of ureteral stents, placement of a percutaneous nephrostomy tube remains the most recommended tool of drainage due to bilateral ureteral obstruction, especially in patients with advanced malignancy. However, the disturbance of the quality of life of those patients remains a major unresolved concern. Beside the unfavorable prognostic potential of the underlying malignancy and the various risk stratification models that have been proposed, the response of the kidney to initial drainage can be anticipated and evaluated by multiple renal prognostic factors, including increased urine output, serum creatinine trajectory, and time-to-nadir serum creatinine after drainage.

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Section: Description Of Summarized Literaturementioning

confidence: 99%

Acute kidney injury due to bilateral malignant ureteral obstruction: Is there an optimal mode of drainage?

Gadelkareem¹,

Abdelraouf²,

El-Taher³

et al. 2022

World J Nephrol

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“…Previous studies have identified several factors of stent failure in patients with MUO, including the pre-stenting serum creatinine (S-Cr) level, performance states (PS), and degree of hydronephrosis [ 12 , 13 ]. We can reduce the number of unnecessary procedures by carefully considering these risk factors.…”

Section: Introductionmentioning

confidence: 99%

Gastrointestinal cancer and bilateral hydronephrosis resulted in a high risk of ureteral stent failure

et al. 2018

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BackgroundUrologists frequently encounter malignant ureteral obstruction (MUO) caused by advanced urological or non-urological malignant disease, but the treatment policy is unclear. The present study examined the risk factors for predicting ureteral stent failure in patients with MUO after ureteral stent insertion and the change in the renal function after retrograde ureteral stent insertion in cases of bilateral hydronephrosis.MethodsA total of 39 patients who required ureteral stent placement for MUO at Yokohama City University Medical Center (Yokohama, Japan) between February 2007 and May 2016 were included in this study. The age, gender, type of cancer, hydronephrosis side, pre-stenting estimated glomerular filtration rate (eGFR), and eGFR increase were assessed as predictive factors for stent failure. Among these 39 patients, 25 showed bilateral hydronephrosis. Thirteen of these patients had bilateral ureteral stents placed, and the remaining 12 had a unilateral ureteral stent placed. The renal function and overall survival (OS) were analyzed between these two groups.ResultsAmong all 39 patients, 9 (23.1%) had stent failure. A univariate analysis revealed that causative disease (gastrointestinal cancer vs. others; p = 0.045) and laterality of hydronephrosis (bilateral vs. unilateral; p = 0.05) were associated with stent failure. A multivariate analysis revealed that only age (hazard ratio, 0.938; 95% confidence interval, 0.883–0.996; p = 0.038) was associated with stent failure. A Kaplan-Meier analysis and log-rank test indicated that having a unilateral ureteral stent placed was not correlated with a lower OS rate than having bilateral ureteral stents placed (p = 0.563). Among patients with bilateral hydronephrosis, the increase in the eGFR of those who had bilateral ureteral stents placed was not significantly different from that of those who had a unilateral ureteral stent placed (p = 0.152).ConclusionsWe revealed that age > 60 years was helpful for predicting stent failure. MUO due to gastrointestinal cancer and bilateral hydronephrosis may be predictive of stent failure. These factors may help urologists decide the optimal time to perform early percutaneous nephrostomy. These findings suggest that patients with bilateral hydronephrosis do not necessarily need to have a ureteral stent placed into both sides of the hydronephrosis.

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“…In our case, the reason why stenting was not insisted upon was that renal function was relatively good. However, previous reports on the relationship between stent placement and renal function suggest that stent failure may occur at 4–5 mg of creatinine [ 10 , 11 ]. The renal function in our case was not in a state of immediate stenting, and radiation therapy was not likely to reduce renal function.…”

Section: Discussionmentioning

confidence: 99%

Successful treatment with radiation therapy for desmoid-type fibromatosis with unilateral hydronephrosis: a case report

et al. 2021

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Background Desmoid-type fibromatosis is a rare disease that can result in hydronephrosis. Hydronephrosis associated with desmoid-type fibromatosis often requires surgery or ureteral stent insertion. Although radiation therapy is recommended for inoperable cases of desmoid-type fibromatosis, there has been no report of treatment for hydronephrosis associated with desmoid-type fibromatosis by radiation therapy alone. We herein report a case of successful treatment for inoperable recurrence of desmoid-type fibromatosis with unilateral hydronephrosis by radiation therapy alone. Case presentation A 43-year-old Japanese female underwent resection of desmoid-type fibromatosis in the right inguinal region and combined resection of the right external iliac vein 5 years before. Other treatment was not performed because of her pregnancy. Four years after surgery, desmoid-type fibromatosis recurred in the right pelvic wall. Cyclooxygenase-2 selective inhibitor treatment was given for 1 year, but her desmoid-type fibromatosis enlarged to more than 10 cm, and she had swelling of her right leg and hydronephrosis of her right kidney. The patient received 50.4 Gy in 28 fractions of prophylactic irradiation using 10 MV X-ray and 9 Gy in five fractions of a sequential boost for the recurrent desmoid-type fibromatosis. Although there was temporary tumor progression at 1 month after radiation therapy, slow regression of the tumor was seen. At 5 years after radiation therapy, there was no disease progression or severe complications. Conclusion We experienced successful treatment for an inoperable case of desmoid-type fibromatosis with hydronephrosis. Moderate-dose radiation therapy alone is an effective and feasible approach for the management of hydronephrosis associated with desmoid-type fibromatosis.

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Serum Creatinine Predicts Success in Retrograde Ureteral Stent Placement in Patients with Pelvic Malignancies

Cited by 14 publications

References 15 publications

Acute kidney injury due to bilateral malignant ureteral obstruction: Is there an optimal mode of drainage?

Acute kidney injury due to bilateral malignant ureteral obstruction: Is there an optimal mode of drainage?

Gastrointestinal cancer and bilateral hydronephrosis resulted in a high risk of ureteral stent failure

Successful treatment with radiation therapy for desmoid-type fibromatosis with unilateral hydronephrosis: a case report

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