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...
Main Authors: | , , |
---|---|
Format: | Article |
Language: | English |
Published: |
Wolters Kluwer Medknow Publications
2015-01-01
|
Series: | Urology Annals |
Subjects: | |
Online Access: | http://www.urologyannals.com/article.asp?issn=0974-7796;year=2015;volume=7;issue=4;spage=499;epage=503;aulast=Sharma |
_version_ | 1811262360058331136 |
---|---|
author | Umesh Sharma Sher Singh Yadav Vinay Tomar |
author_facet | Umesh Sharma Sher Singh Yadav Vinay Tomar |
author_sort | Umesh Sharma |
collection | DOAJ |
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 H2O in 48 (30%); 10–20 cm H2O in 64 (40%) and >20 cm H2O 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. |
first_indexed | 2024-04-12T19:23:58Z |
format | Article |
id | doaj.art-6b7b34dbb9634151b123119fc6dfd1a0 |
institution | Directory Open Access Journal |
issn | 0974-7796 0974-7834 |
language | English |
last_indexed | 2024-04-12T19:23:58Z |
publishDate | 2015-01-01 |
publisher | Wolters Kluwer Medknow Publications |
record_format | Article |
series | Urology Annals |
spelling | doaj.art-6b7b34dbb9634151b123119fc6dfd1a02022-12-22T03:19:32ZengWolters Kluwer Medknow PublicationsUrology Annals0974-77960974-78342015-01-017449950310.4103/0974-7796.157960Factors influencing recoverability of renal function after urinary diversion through percutaneous nephrostomyUmesh SharmaSher Singh YadavVinay TomarContext: 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 H2O in 48 (30%); 10–20 cm H2O in 64 (40%) and >20 cm H2O 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.http://www.urologyannals.com/article.asp?issn=0974-7796;year=2015;volume=7;issue=4;spage=499;epage=503;aulast=SharmaCorticomedullary differentiationdifferential creatinine clearanceintrapelvic pressurepercutaneous nephrostomy |
spellingShingle | Umesh Sharma Sher Singh Yadav Vinay Tomar Factors influencing recoverability of renal function after urinary diversion through percutaneous nephrostomy Urology Annals Corticomedullary differentiation differential creatinine clearance intrapelvic pressure 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 | Corticomedullary differentiation differential creatinine clearance intrapelvic pressure percutaneous nephrostomy |
url | http://www.urologyannals.com/article.asp?issn=0974-7796;year=2015;volume=7;issue=4;spage=499;epage=503;aulast=Sharma |
work_keys_str_mv | AT umeshsharma factorsinfluencingrecoverabilityofrenalfunctionafterurinarydiversionthroughpercutaneousnephrostomy AT shersinghyadav factorsinfluencingrecoverabilityofrenalfunctionafterurinarydiversionthroughpercutaneousnephrostomy AT vinaytomar factorsinfluencingrecoverabilityofrenalfunctionafterurinarydiversionthroughpercutaneousnephrostomy |