Ultrasound evaluation of obstructive uropathy and its hemodynamic responses in southwest Nigeria

Abstract

Purpose:To determine the renal arterial hemodynamic changes induced by obstructive uropathy using Doppler ultrasonography.Materials and Methods:60 adult subjects with suspected obstructive uropathy and 60 asymptomatic apparently healthy controls with normal renal ultrasound features were evaluated.B-mode sonography of the kidneys and spectral Doppler examination of the renal interlobar arteries of all the participants were performed. The mean resistive indices (mRI) of both interlobar arteries were obtained and compared to that of the controls. The mRI of bilaterally obstructed kidneys were also compared with the mRI of unilaterally obstructed kidneys.Results:The mRI of the right and left kidneys of subjects were 0.72±0.04 and 0.69±0.06 while those of the controls were 0.64±0.04 and 0.63±0.03 respectively. The mRI for the grades of caliectasis increased from grade I (0.72±0.03) to grade II (0.73±0.03) and grade III (0.73±0.02) but fell within the most severe levels of obstruction (0.69±0.07). There was no statistically significant relationship between the grades of caliectasis and unilateral or bilateral obstruction for both kidneys. The results show a sensitivity and specificity of 86.7% and 90% respectively when mRI≥0.7 was used to determine presence of obstruction.Conclusion:Renal duplex sonography is highly sensitive and specific for diagnosis of obstructive uropathy. Increased resistive index of the obstructed kidney may be a useful diagnostic tool in situations where intravenous urography cannot be done or is contraindicated.

Non-invasive evaluation of obstruction after ureteroscopic stone removal: Role of renal resistive index assessment

“…On the other hand, evaluation and follow-up of possible obstructive status after such interventions with minimal or non-invasive means carry considerable importance for the involved cases. Renal Doppler USG and RI value assessment can be a useful tool in the non-invasive evaluation of upper urinary tract obstruction on this aspect (4,15). Related with this issue, Apoku et al reported that renal Doppler sonography is highly sensitive and specific for the diagnosis of obstructive uropathy.…”

“…Renal Doppler ultrasonography (USG) may be one of the non-invasive diagnostic methods to help us in evaluating the degree as well as the course of the ureteral obstruction following endoscopic ureteral stone treatment. It has been well shown that changes in the degree of hydronephrosis and resistive index values (Δ%) after ureteroscopic stone removal could provide important information regarding the severity (grade) of obstruction (4,5). Insertion of an ureteral stent after ureteroscopic procedures can be a rational option to avoid postoperative obstruction.…”

Association between Endothelial Dysfunction, Biomarkers of Renal Function, and Disease Severity in Sickle Cell Disease

“…This finding may imply that, because biomarkers of renal function correlate with FMD in SCD, whereas other biomarkers of SCD disease severity do not, monitoring and management of renal function will be critical in SCD to preserve FMD and prevent ED. Although RARI is a proven tool for evaluating various renal diseases (32)(33)(34), it should also be noted that RARI is also an indicator of cardiovascular outcome (35). In a study by Ikee et al (36), biochemical and histopathologic parameters showed statistically significant correlations with RI.…”

Transrectal doppler sonography of benign prostatic enlargement in Nigerian Men

“…[15] BPE is common in our population with a community prevalence of about 24%[16] and also accounts for up to 27% of obstructive uropathy cases. [17] Although pressure flow studies (PFS) are considered the most reliable method for evaluating BOO, they are invasive and complicated. [18] TRUS is a promising alternative to PFS because of its minimal invasiveness.…”