Introduction: Obstructive uropathy (OU) is defined as an alteration in any level of the urinary tract that is caused by abnormalities of its system organs, or external pathological factors. Hydronephrosis and progressive renal impairment are signs of upper-tract OU. OU accounted to be around 0,9% - 3,8% of prevalence for etiology of hydronephrosis. The aim of OU treatment is to achieve optimal urinary diversion, either by retrograde intra-ureteral stenting or percutaneous drainage. However, improvement of renal function after urinary diversion is not always evident. The purpose of this study was to identify predictive factors of improvement in renal function following ureteral stent insertion or percutaneous nephrostomy in OU cases. Methods: This was a retrospective, single-center study on patients with OU, who underwent ureteral stenting with Double J (DJ) stent or percutaneous nephrostomy. Several commonly measured clinical indices were documented, including preoperative haemoglobin, Ht, leucocyte, thrombocyte, serum creatinine, blood urea, electrolyte, blood urea to serum creatinine ratio, and renal parenchymal thickness. We focused on finding which parameters correlated with postsurgical decrease in serum creatinine level. Result: We evaluate 567 patients that underwent DJ stent insertion and percutaneous nephrostomy. There was a statistically significant relationship between parenchymal thickness with post-operative creatinine serum decrease, with an OR of 11.24 (p<0.01, CI 7,5 – 16,8). Another parameter that has a statistically significant relationship with successful operative outcomes was blood urea to serum creatinine with OR = 27,9 (p-value < 0.01, 95% CI 17,4 – 44,8. Other laboratory factors had no statistical significance in predicting renal function recoverability. Conclusion: There was a statistically significant relationship between renal parenchymal thickness and blood urea-creatinine ratio with a favourable operational outcome in OU, as evidenced by a reduction in postoperative creatinine serum level.
Objective: This study aim to see the significance of R.E.N.A.L-NS in our center. Material & Methods: We retrospectively collected all the data of RCC patients that underwent partial nephrectomy (PN) in Cipto Mangunkusumo Hospital from January 2010-January 2018, with complete CT-scan examination. Patients with single kidney were excluded from our study. We evaluated intraoperative blood loss, length of operation, post operative length of stay, post operative kidney function, and complications as the perioperative parameters. Patients were categorized into 3 category based their complexity from RENAL-NS into: low (4-6), moderate (7-9), and high (10-12). Complications were based on Clavien-Dindo classification. Perioperative outcomes were analyzed based on the stratification of the patients and analyzed using ANOVA and chi-square. Results: We evaluated 25 partial nephrectomy cases which are suitable with inclusion and exclusion criteria. There were 8 (32%) low, 14 (56%) medium, and 3 (12%) high complexity cases. Median age of patients were 61 (46-71) years old, with mean tumor diameter 72.07 (+ 38.9) mm. Nine (36%) patients underwent open procedure and 16 (64%) underwent laparoscopic procedure. The laparoscopic procedure was tend to the lower complexity of R.E.N.A.L score (p=0.048). Higher complexity of R.E.N.A.L score correlated with higher blood loss (p<0.001), length of stay (p<0.001), complication rate (p<0.001), and length of operation (p=0.033). Conclusion: R.E.N.A.L-NS has a role for a selection of type of procedure and a prediction of perioperative outcome in partial nephrectomy. R.E.N.A.L-NS can be used in daily basis as it could determine the procedure and several outcomes of the partial nephrectomy procedure.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.