The Risk of Upper Urinary Tract Involvement in Patients With Ketamine-Associated Uropathy
Purpose The aims of this study were to investigate the prevalence of upper tract involvement in ketamine-associated uropathy, and to determine the predictors of hydronephrosis in patients with a history of ketamine abuse. Methods This was a cross-sectional study of a prospective cohort of patients w...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Korean Continence Society
2017-06-01
|
| Series: | International Neurourology Journal |
| Subjects: | |
| Online Access: | http://www.einj.org/upload/pdf/inj-1732704-352.pdf |
| _version_ | 1828942221061128192 |
|---|---|
| author | Chi-Hang Yee Jeremy Yuen-Chun Teoh Pui-Tak Lai Vivian Yee-Fong Leung Winnie Chiu-Wing Chu Wai-man Lee Yuk-Him Tam Chi-Fai Ng |
| author_facet | Chi-Hang Yee Jeremy Yuen-Chun Teoh Pui-Tak Lai Vivian Yee-Fong Leung Winnie Chiu-Wing Chu Wai-man Lee Yuk-Him Tam Chi-Fai Ng |
| author_sort | Chi-Hang Yee |
| collection | DOAJ |
| description | Purpose The aims of this study were to investigate the prevalence of upper tract involvement in ketamine-associated uropathy, and to determine the predictors of hydronephrosis in patients with a history of ketamine abuse. Methods This was a cross-sectional study of a prospective cohort of patients with ketamine-associated uropathy. Data including demographics, pattern of ketamine abuse, pelvic pain and urgency or frequency (PUF) symptom score, uroflowmetry (UFM) parameters, serum renal function, and liver function tests were collected. Upon consultation, ultrasonography was performed to assess the function of the urinary system. Results From December 2011 to October 2015, we treated 572 patients with ketamine-associated uropathy. Of these patients, 207 (36.2%) had managed to achieve abstinence at the time of their first consultation. Ninety-six patients (16.8%) in the cohort were found to have hydronephrosis on ultrasonography. Univariate analysis identified age, duration of ketamine abuse, PUF symptom score, voided volume on UFM, serum creatinine levels >100 μmol/L, and an abnormal serum liver enzyme profile as factors associated with hydronephrosis. Logistic regression revealed the following parameters to be statistically related to hydronephrosis: age (adjusted odds ratio [OR], 1.090; 95% confidence interval [CI], 1.020–1.166; P=0.012), functional bladder capacity (adjusted OR, 0.997; 95% CI, 0.995–0.999; P=0.029), serum creatinine >100 μmol/L (adjusted OR, 3.107; 95% CI, 1.238–7.794; P=0.016, and an abnormal serum liver enzyme profile (adjusted OR, 1.967; 95% CI, 1.213–3.187; P=0.006). Conclusions Ketamine-associated uropathy can involve the upper urinary tract. Patient demographics as well as investigations of UFM, renal function tests, and liver function tests may allow us to identify at-risk patients. |
| first_indexed | 2024-12-14T03:50:45Z |
| format | Article |
| id | doaj.art-11f069aadf5348ddb4a378e62dd36e3c |
| institution | Directory Open Access Journal |
| issn | 2093-4777 2093-6931 |
| language | English |
| last_indexed | 2024-12-14T03:50:45Z |
| publishDate | 2017-06-01 |
| publisher | Korean Continence Society |
| record_format | Article |
| series | International Neurourology Journal |
| spelling | doaj.art-11f069aadf5348ddb4a378e62dd36e3c2022-12-21T23:18:13ZengKorean Continence SocietyInternational Neurourology Journal2093-47772093-69312017-06-0121212813210.5213/inj.1732704.352672The Risk of Upper Urinary Tract Involvement in Patients With Ketamine-Associated UropathyChi-Hang Yee0Jeremy Yuen-Chun Teoh1Pui-Tak Lai2Vivian Yee-Fong Leung3Winnie Chiu-Wing Chu4Wai-man Lee5Yuk-Him Tam6Chi-Fai Ng7 Prince of Wales Hospital, SH Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong Kong Prince of Wales Hospital, SH Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong Kong Prince of Wales Hospital, SH Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong Kong Department of Imaging and Interventional Radiology, Prince of Wales Hospital. Hong Kong Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong. Hong Kong Prince of Wales Hospital, SH Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong Kong Prince of Wales Hospital, Department of Surgery, The Chinese University of Hong Kong. Hong Kong Prince of Wales Hospital, SH Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong KongPurpose The aims of this study were to investigate the prevalence of upper tract involvement in ketamine-associated uropathy, and to determine the predictors of hydronephrosis in patients with a history of ketamine abuse. Methods This was a cross-sectional study of a prospective cohort of patients with ketamine-associated uropathy. Data including demographics, pattern of ketamine abuse, pelvic pain and urgency or frequency (PUF) symptom score, uroflowmetry (UFM) parameters, serum renal function, and liver function tests were collected. Upon consultation, ultrasonography was performed to assess the function of the urinary system. Results From December 2011 to October 2015, we treated 572 patients with ketamine-associated uropathy. Of these patients, 207 (36.2%) had managed to achieve abstinence at the time of their first consultation. Ninety-six patients (16.8%) in the cohort were found to have hydronephrosis on ultrasonography. Univariate analysis identified age, duration of ketamine abuse, PUF symptom score, voided volume on UFM, serum creatinine levels >100 μmol/L, and an abnormal serum liver enzyme profile as factors associated with hydronephrosis. Logistic regression revealed the following parameters to be statistically related to hydronephrosis: age (adjusted odds ratio [OR], 1.090; 95% confidence interval [CI], 1.020–1.166; P=0.012), functional bladder capacity (adjusted OR, 0.997; 95% CI, 0.995–0.999; P=0.029), serum creatinine >100 μmol/L (adjusted OR, 3.107; 95% CI, 1.238–7.794; P=0.016, and an abnormal serum liver enzyme profile (adjusted OR, 1.967; 95% CI, 1.213–3.187; P=0.006). Conclusions Ketamine-associated uropathy can involve the upper urinary tract. Patient demographics as well as investigations of UFM, renal function tests, and liver function tests may allow us to identify at-risk patients.http://www.einj.org/upload/pdf/inj-1732704-352.pdfCystitisHydronephrosisKetamineLower Urinary Tract SymptomsUrination Disorders |
| spellingShingle | Chi-Hang Yee Jeremy Yuen-Chun Teoh Pui-Tak Lai Vivian Yee-Fong Leung Winnie Chiu-Wing Chu Wai-man Lee Yuk-Him Tam Chi-Fai Ng The Risk of Upper Urinary Tract Involvement in Patients With Ketamine-Associated Uropathy International Neurourology Journal Cystitis Hydronephrosis Ketamine Lower Urinary Tract Symptoms Urination Disorders |
| title | The Risk of Upper Urinary Tract Involvement in Patients With Ketamine-Associated Uropathy |
| title_full | The Risk of Upper Urinary Tract Involvement in Patients With Ketamine-Associated Uropathy |
| title_fullStr | The Risk of Upper Urinary Tract Involvement in Patients With Ketamine-Associated Uropathy |
| title_full_unstemmed | The Risk of Upper Urinary Tract Involvement in Patients With Ketamine-Associated Uropathy |
| title_short | The Risk of Upper Urinary Tract Involvement in Patients With Ketamine-Associated Uropathy |
| title_sort | risk of upper urinary tract involvement in patients with ketamine associated uropathy |
| topic | Cystitis Hydronephrosis Ketamine Lower Urinary Tract Symptoms Urination Disorders |
| url | http://www.einj.org/upload/pdf/inj-1732704-352.pdf |
| work_keys_str_mv | AT chihangyee theriskofupperurinarytractinvolvementinpatientswithketamineassociateduropathy AT jeremyyuenchunteoh theriskofupperurinarytractinvolvementinpatientswithketamineassociateduropathy AT puitaklai theriskofupperurinarytractinvolvementinpatientswithketamineassociateduropathy AT vivianyeefongleung theriskofupperurinarytractinvolvementinpatientswithketamineassociateduropathy AT winniechiuwingchu theriskofupperurinarytractinvolvementinpatientswithketamineassociateduropathy AT waimanlee theriskofupperurinarytractinvolvementinpatientswithketamineassociateduropathy AT yukhimtam theriskofupperurinarytractinvolvementinpatientswithketamineassociateduropathy AT chifaing theriskofupperurinarytractinvolvementinpatientswithketamineassociateduropathy AT chihangyee riskofupperurinarytractinvolvementinpatientswithketamineassociateduropathy AT jeremyyuenchunteoh riskofupperurinarytractinvolvementinpatientswithketamineassociateduropathy AT puitaklai riskofupperurinarytractinvolvementinpatientswithketamineassociateduropathy AT vivianyeefongleung riskofupperurinarytractinvolvementinpatientswithketamineassociateduropathy AT winniechiuwingchu riskofupperurinarytractinvolvementinpatientswithketamineassociateduropathy AT waimanlee riskofupperurinarytractinvolvementinpatientswithketamineassociateduropathy AT yukhimtam riskofupperurinarytractinvolvementinpatientswithketamineassociateduropathy AT chifaing riskofupperurinarytractinvolvementinpatientswithketamineassociateduropathy |