Predictors of renal recovery in renal failure secondary to bilateral obstructive urolithiasis

Abstract

ObjectivesTo identify factors predicting renal recovery in patients presenting with renal failure secondary to bilateral obstructing urolithiasis.Patients and methodsData from electronic records of consecutive adult patients presenting with bilateral obstructing urolithiasis between January 2007 and April 2011 were retrieved. Ultrasonography of the abdomen, and kidney, ureter, bladder (KUB study) X-ray or abdominal non-contrast computed tomography confirmed the diagnosis. Interventional radiologists placed bilateral nephrostomies. Definitive intervention was planned after reaching nadir creatinine. Renal recovery was defined as nadir creatinine of ⩽2 mg/dL.ResultsIn all, 53 patients were assessed, 50 (94.3%) were male, and 18 (33.9%) were aged ⩽40 years. Renal recovery was achieved in 20 patients (37.7%). A symptom duration of ⩽25 days (P < 0.01), absence of hypertension (P = 0.018), maximum renal parenchymal thickness of >16.5 mm (P = 0.001), and haemoglobin >9.85 g/dL (P < 0.01) were significant on unadjusted analysis. Symptom duration of ⩽25 days alone remained significant after adjusted analysis. Symptom duration of ⩽25 days (hazard ratio (HR) 13.83, 95% confidence interval (CI) 4.52–42.26; P < 0.01), parenchymal thickness of ⩾16.5 mm (HR 5.91, 95% CI 1.94–17.99; P = 0.002), and absence of hypertension (HR 9.99, CI 95% 1.32–75.37; P = 0.026) were significantly related to time to nadir creatinine. Symptom duration of ⩽25 days (HR 17.44, 95% CI 2.48–122.79; P = 0.004) alone remained significant after adjusted analysis. A symptom duration of ⩽25 days (P = 0.007) was 22-times more likely to indicate renal recovery.ConclusionsShorter symptom duration (⩽25 days) is predictive of renal recovery in renal failure secondary to bilateral obstructive urolithiasis.

Percutaneous nephrostomy versus JJ ureteric stent as the initial drainage method in kidney stone patients presenting with acute kidney injury: A prospective randomized study

“…Also, the incidence of mucosal injury and ureteral perforation was increased in upper ureteric stones, stone size >1.5 cm and anuric period of 3 days, which was consistent with findings of Yossepowitch et al ., Varda et al ., Savic et al . and Rajadoss et al 17–20 . PCN insertion failure and pelvic extravasation were more likely to occur in cases of mild HN and renal stone size >2.5 cm, which was consistent with the findings of Sommer et al .…”

Predictors of nadir serum creatinine after drainage of bilaterally obstructed kidneys due to different etiologies

“…On average, the preoperative SCr was 6.13 ± 3.2 mg/dl. It had no statistically significant effect the improvement in SCr which was similar to the results [18][19][20]. However, it was different from the previous results found that the low SCr at presentation was a statistically significant predictor for recoverability of renal functions in patients with Po-AKI [5,14,21].…”

“…The latter processes are usually reflected on the patient's physical conditions, functional performance, and they can competently compensate for the pathophysiological sequels of AKI after drainage. These functional competences may help making a decision of invasive interventions such as JJ placement [1,6,18,19]. This is in contrast with patients with MUO who have bad general performance and short life expectancy due to the advanced malignancy [20,22].…”

Calculus Renal Failure

“…Prolonged obstruction and comorbidity like hypertension will lead to non-functioning kidney units that ultimately ended up with nephrectomy. 24 In our study, 20(29.41%) Patients with non-functioning kidneys, underwent nephrectomy.…”