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Factors influencing recoverability of renal function after urinary diversion through percutaneous nephrostomy

CONTEXT: Various factors predict recoverability of kidney function preoperatively. Placement of percutaneous nephrostomy (PCN) and measuring the differential creatinine clearance (diff. %CrCl) is still regarded as a simple and reliable method. AIMS: The aim was to evaluate correlation between renal...

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Autores principales: Sharma, Umesh, Yadav, Sher Singh, Tomar, Vinay
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4660704/
https://www.ncbi.nlm.nih.gov/pubmed/26692673
http://dx.doi.org/10.4103/0974-7796.157960
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author Sharma, Umesh
Yadav, Sher Singh
Tomar, Vinay
author_facet Sharma, Umesh
Yadav, Sher Singh
Tomar, Vinay
author_sort Sharma, Umesh
collection PubMed
description CONTEXT: Various factors predict recoverability of kidney function preoperatively. Placement of percutaneous nephrostomy (PCN) and measuring the differential creatinine clearance (diff. %CrCl) is still regarded as a simple and reliable method. AIMS: The aim was to evaluate correlation between renal cortical thickness (CT), hydronephrosis, intrapelvic pressure (IPP), PCN output, renal morphological factors such as length, width, echogenicity, corticomedullary differentiation (CMD), status of c/l kidney, and presence of infection which can predict recoverable function. SETTINGS AND DESIGN: A prospective study done between July 2013 and June 2014 in Urology Department. SUBJECTS AND METHODS: Hundred and sixty patients of supravesical obstruction for various causes who need PCN either due to chronic renal failure or nonvisualized kidney on contrast study, were included. IPP was measured during PCN placement. After 4 weeks 24 h urine was sent for CrCl and urine pH. STATISTICAL ANALYSIS USED: Correlation of continuous and categorical variables with dependent variable (diff. %CrCl) was formulated using spearman correlation and Mann–Whitney U test. Simple and multiple linear regression analysis were performed. RESULTS: The study includes 160 patients with median age of 65.5 years. Hydronephrosis were due to stone in 76 (47.5%), pelviureteric junction obstruction (PUJO) in 40 (25%), cancer in 32 (20%), others in 12 cases (7.5%). IPP was <10 cm H(2)O in 48 (30%); 10–20 cm H(2)O in 64 (40%) and >20 cm H(2)O in 48 (30%). There was significant correlation between IPP and diff. %CrCl with correlation coefficient ρ = 0.509 (P = 0.0001). CONCLUSIONS: CT, parenchymal echogenicity, CMD, pre-PCN creatinine, and status of c/l kidney are the only independent variables which can predict the renal function while other variables like renal size, urine output, infection, hydronephrosis lost their statistical significance in multivariate analysis. Furthermore, IPP measured before PCN directly correlated with daily urine output and diff. %CrCl.
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spelling pubmed-46607042015-12-11 Factors influencing recoverability of renal function after urinary diversion through percutaneous nephrostomy Sharma, Umesh Yadav, Sher Singh Tomar, Vinay Urol Ann Original Article CONTEXT: Various factors predict recoverability of kidney function preoperatively. Placement of percutaneous nephrostomy (PCN) and measuring the differential creatinine clearance (diff. %CrCl) is still regarded as a simple and reliable method. AIMS: The aim was to evaluate correlation between renal cortical thickness (CT), hydronephrosis, intrapelvic pressure (IPP), PCN output, renal morphological factors such as length, width, echogenicity, corticomedullary differentiation (CMD), status of c/l kidney, and presence of infection which can predict recoverable function. SETTINGS AND DESIGN: A prospective study done between July 2013 and June 2014 in Urology Department. SUBJECTS AND METHODS: Hundred and sixty patients of supravesical obstruction for various causes who need PCN either due to chronic renal failure or nonvisualized kidney on contrast study, were included. IPP was measured during PCN placement. After 4 weeks 24 h urine was sent for CrCl and urine pH. STATISTICAL ANALYSIS USED: Correlation of continuous and categorical variables with dependent variable (diff. %CrCl) was formulated using spearman correlation and Mann–Whitney U test. Simple and multiple linear regression analysis were performed. RESULTS: The study includes 160 patients with median age of 65.5 years. Hydronephrosis were due to stone in 76 (47.5%), pelviureteric junction obstruction (PUJO) in 40 (25%), cancer in 32 (20%), others in 12 cases (7.5%). IPP was <10 cm H(2)O in 48 (30%); 10–20 cm H(2)O in 64 (40%) and >20 cm H(2)O in 48 (30%). There was significant correlation between IPP and diff. %CrCl with correlation coefficient ρ = 0.509 (P = 0.0001). CONCLUSIONS: CT, parenchymal echogenicity, CMD, pre-PCN creatinine, and status of c/l kidney are the only independent variables which can predict the renal function while other variables like renal size, urine output, infection, hydronephrosis lost their statistical significance in multivariate analysis. Furthermore, IPP measured before PCN directly correlated with daily urine output and diff. %CrCl. Medknow Publications & Media Pvt Ltd 2015 /pmc/articles/PMC4660704/ /pubmed/26692673 http://dx.doi.org/10.4103/0974-7796.157960 Text en Copyright: © Urology Annals http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution NonCommercial ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non commercially, as long as the author is credited and the new creations are licensed under the identical terms.
spellingShingle Original Article
Sharma, Umesh
Yadav, Sher Singh
Tomar, Vinay
Factors influencing recoverability of renal function after urinary diversion through percutaneous nephrostomy
title Factors influencing recoverability of renal function after urinary diversion through percutaneous nephrostomy
title_full Factors influencing recoverability of renal function after urinary diversion through percutaneous nephrostomy
title_fullStr Factors influencing recoverability of renal function after urinary diversion through percutaneous nephrostomy
title_full_unstemmed Factors influencing recoverability of renal function after urinary diversion through percutaneous nephrostomy
title_short Factors influencing recoverability of renal function after urinary diversion through percutaneous nephrostomy
title_sort factors influencing recoverability of renal function after urinary diversion through percutaneous nephrostomy
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4660704/
https://www.ncbi.nlm.nih.gov/pubmed/26692673
http://dx.doi.org/10.4103/0974-7796.157960
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