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Supranormal differential renal function in adults with ureteropelvic junction obstruction: Does it really exist?

INTRODUCTION: Some patients with ureteropelvic junction obstruction (UPJO) have supranormal differential renal function (snDRF). We aimed to study the outcomes of pyeloplasty in adult patients with UPJO and either snDRF or normal differential renal function (nDRF) and to identify preoperative factor...

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Autores principales: Elbaset, M. A., Ezzat, Osama, Elgamal, Mostafa, Sharaf, M. A., Elmeniar, A. M., Abdelhamid, Abdalla, Osman, Yasser
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7531368/
https://www.ncbi.nlm.nih.gov/pubmed/33082636
http://dx.doi.org/10.4103/iju.IJU_109_20
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author Elbaset, M. A.
Ezzat, Osama
Elgamal, Mostafa
Sharaf, M. A.
Elmeniar, A. M.
Abdelhamid, Abdalla
Osman, Yasser
author_facet Elbaset, M. A.
Ezzat, Osama
Elgamal, Mostafa
Sharaf, M. A.
Elmeniar, A. M.
Abdelhamid, Abdalla
Osman, Yasser
author_sort Elbaset, M. A.
collection PubMed
description INTRODUCTION: Some patients with ureteropelvic junction obstruction (UPJO) have supranormal differential renal function (snDRF). We aimed to study the outcomes of pyeloplasty in adult patients with UPJO and either snDRF or normal differential renal function (nDRF) and to identify preoperative factors responsible for the snDRF phenomenon. MATERIALS AND METHODS: We retrospectively retrieved data for all patients who underwent pyeloplasty and had snDRF (differential renal function [DRF] ≥55%) and nDRF (DRF between 45 and 55%) preoperatively. Preoperative radiological data using computed tomography or magnetic resonance imaging were correlated with the presence of snDRF phenomenon. In addition, scintigraphic findings pre- and post-operatively were also assessed to evaluate the functional outcomes. RESULTS: Of a total of 856 patients, 31 had snDRF (group 1) and 42 had nDRF (group 2). After a mean of 37 months’ follow-up in Group 1, 22 patients developed DRF reduction with non-obstructive pattern. Mean DRF % decreased from 59 ± 2.8 to 48 ± 13 (P < 0.0001). However, in Group 2, five patients had DRF decrease. Four patients developed snDRF phenomenon postoperatively. Increased renal pelvis volume ≥50 mm(3) and increased anteroposterior pelvic diameter (APD) ≥37 mm were found to predict snDRF phenomenon. The same findings, in addition to preoperative snDRF, correlated with postoperative DRF decrease. CONCLUSION: SnDRF function could be expected in patients with increased renal pelvis volume and APD. The absolute value or changes in DRF are not reliable to judge treatment failure.
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spelling pubmed-75313682020-10-19 Supranormal differential renal function in adults with ureteropelvic junction obstruction: Does it really exist? Elbaset, M. A. Ezzat, Osama Elgamal, Mostafa Sharaf, M. A. Elmeniar, A. M. Abdelhamid, Abdalla Osman, Yasser Indian J Urol Original Article INTRODUCTION: Some patients with ureteropelvic junction obstruction (UPJO) have supranormal differential renal function (snDRF). We aimed to study the outcomes of pyeloplasty in adult patients with UPJO and either snDRF or normal differential renal function (nDRF) and to identify preoperative factors responsible for the snDRF phenomenon. MATERIALS AND METHODS: We retrospectively retrieved data for all patients who underwent pyeloplasty and had snDRF (differential renal function [DRF] ≥55%) and nDRF (DRF between 45 and 55%) preoperatively. Preoperative radiological data using computed tomography or magnetic resonance imaging were correlated with the presence of snDRF phenomenon. In addition, scintigraphic findings pre- and post-operatively were also assessed to evaluate the functional outcomes. RESULTS: Of a total of 856 patients, 31 had snDRF (group 1) and 42 had nDRF (group 2). After a mean of 37 months’ follow-up in Group 1, 22 patients developed DRF reduction with non-obstructive pattern. Mean DRF % decreased from 59 ± 2.8 to 48 ± 13 (P < 0.0001). However, in Group 2, five patients had DRF decrease. Four patients developed snDRF phenomenon postoperatively. Increased renal pelvis volume ≥50 mm(3) and increased anteroposterior pelvic diameter (APD) ≥37 mm were found to predict snDRF phenomenon. The same findings, in addition to preoperative snDRF, correlated with postoperative DRF decrease. CONCLUSION: SnDRF function could be expected in patients with increased renal pelvis volume and APD. The absolute value or changes in DRF are not reliable to judge treatment failure. Wolters Kluwer - Medknow 2020 2020-07-01 /pmc/articles/PMC7531368/ /pubmed/33082636 http://dx.doi.org/10.4103/iju.IJU_109_20 Text en Copyright: © 2020 Indian Journal of Urology http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Original Article
Elbaset, M. A.
Ezzat, Osama
Elgamal, Mostafa
Sharaf, M. A.
Elmeniar, A. M.
Abdelhamid, Abdalla
Osman, Yasser
Supranormal differential renal function in adults with ureteropelvic junction obstruction: Does it really exist?
title Supranormal differential renal function in adults with ureteropelvic junction obstruction: Does it really exist?
title_full Supranormal differential renal function in adults with ureteropelvic junction obstruction: Does it really exist?
title_fullStr Supranormal differential renal function in adults with ureteropelvic junction obstruction: Does it really exist?
title_full_unstemmed Supranormal differential renal function in adults with ureteropelvic junction obstruction: Does it really exist?
title_short Supranormal differential renal function in adults with ureteropelvic junction obstruction: Does it really exist?
title_sort supranormal differential renal function in adults with ureteropelvic junction obstruction: does it really exist?
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7531368/
https://www.ncbi.nlm.nih.gov/pubmed/33082636
http://dx.doi.org/10.4103/iju.IJU_109_20
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