Acute Kidney Injury Caused by Obstructive Nephropathy

Abstract

Acute kidney injury secondary to obstructive nephropathy is a frequent event that accounts for 5 to 10% of all acute kidney injury cases and has a great impact on the morbidity and mortality in those affected. The obstruction in the urinary tract has a profound impact on kidney function due to damage produced by ischemic and inflammatory factors that have been associated with intense fibrosis. This pathology is characterized by its effects on the management of fluids, electrolytes, and the acid-base mechanisms by the renal tubule; consequently, metabolic acidosis, hyperkalemia, uremia, and anuria are seen during acute kidney injury due to obstructive nephropathy, and after drainage, polyuria may occur. Acute urine retention is the typical presentation. The diagnosis consists of a complete medical history and should include changes in urinary voiding and urgency and enuresis, history of urinary tract infections, hematuria, renal lithiasis, prior urinary interventions, and constipation. Imaging studies included tomography or ultrasound in which hydronephrosis can be seen. Management includes, in addition to drainage of the obstructed urinary tract system, providing supportive treatment, correcting all the metabolic abnormalities, and initiating renal replacement therapy when required. Although its recovery is in most cases favorable, it seems to be an undervalued event in nephrology and urology. This is because it is mistakenly believed that the resolution and recovery of kidney function is complete once the urinary tract is unobstructed. It can have serious kidney sequelae. In this review, we report the epidemiology, incidence, pathophysiological mechanisms, diagnosis, and treatment of acute kidney injury due to obstructive nephropathy.

Obstructive oligo-anuria revealing pelvic gynecological cancers, analysis of a series of 102 cases

“…Obstructive anuria is a frequent cause of the AKI and represents 5–10% of the cases [ 6 ] and 22% of the cases of the AKI in the elderly population [ 7 ]. It constitutes a diagnostic and a therapeutic emergency involving the patient's vital prognosis and requiring multidisciplinary management.…”

Severe Hydronephrosis Secondary to Ovarian Serous Carcinoma

“…4 Hydronephrosis typically presents with acute urine retention. 10 In addition, clinical symptoms include urinary urgency, frequent urination, incomplete urination, change in urinary voiding, enuresis, hematuria, dysuria, as well as flank, abdominal, or groin pain, fever, infection, nausea, and vomiting. 11,12 In general, symptom severity is dependent on the type, cause, and severity of the blockage.…”

Protective Effects of Nootkatone on Renal Inflammation, Apoptosis, and Fibrosis in a Unilateral Ureteral Obstructive Mouse Model

“…Obstructive nephropathy is also a significant health problem in the world, which can be classified as a secondary injury of acute kidney injury (AKI). It is a frequent event that can be accounted for in around 10% of all AKI cases [34] and up to 22% in elder subject s [35]. Another report indicated that the kidney stone, an obstructive disorder in the kidney, had a 51 to 68% increased risk for CKD by diagnosis and 25% to 44% increased risk for CKD by serum creatinine level judgment [36].…”