Prognostic Parameters for the Recovery of Renal Function in Patients With Obstructive Uropathy

Bundu, Aristo; Danarto, H R

doi:10.32421/juri.v25i1.401

Cited by 1 publication

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“…The delayed treatment of a presenting patient might be the cause of the alteration of blood urea to creatinine ratio as the estimation of severity of kidney injury. This finding is also in line with the study by Bundu et al (2018), which reported that a ratio of blood urea to serum creatinine > 10 can be used as a prognostic factor to predict a successful OU therapy. 9 In Uchino et al (2012), the ratio of blood urea to creatinine could differentiate pre-renal and intra-renal cause of kidney failure.…”

Section: Discussionsupporting

confidence: 91%

“…However, several other studies have found different results. Bundu et al (2018), found that pre-operative haemoglobin levels greater than 10 mg/dL and blood urea to creatinine ratio greater than 10 was positively associated with recoverability of renal function after OU surgery. Another study by Sharma et al (2015) revealed that pre-operative serum creatinine level of less than 1.5 mg% also correlated with reversible kidney function.…”

Section: Discussionmentioning

confidence: 96%

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Predictive factor of renal function recoverability in upper-tract obstructive uropathy after percutaneous nephrostomy and Double -J stent insertion in Indonesian National Referral Hospital

Soeroto

Situmorang²,

Rasyid³

2022

F1000Res

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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.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 96%