Deferred drainage-related complications in patients with palliative nephrostomy

Abstract

Aim. To assess the frequency and timing of drainage associated complications in patients after palliative nephrostomy with nephrostomy tubes of various diameter and design. To establish a relationship between the presence of diabetes mellitus and the risk of acute pyelonephritis.Materials and methods. The records of 73 patients who received care between January 2018 and May 2021 were retrospectively reviewed for complications, related to nephrostomy tube. 201 cases of patient attendance due to nephrostomy tube dis-lodgement, nephrostomy tube obstruction and pyelonephritis were analyzed. The frequency and timing of the onset of complications in groups of patients with J-type (<12 Fr) and balloon-type (≥12 Fr) drains were separately assessed.Results. In total, there were 100 visits of patients with J-type catheters and 101 visits with balloon nephrostomy catheters. The reasons for attendance among patients with J-type nephrostomy tube were: impaired drainage function (46 %), pyelonephritis (35 %) and dislocation of the catheter (19 %); and for patients with balloon catheters: pyelonephritis (39 %), impaired drainage function (34 %), dislocation (27 %). Patients with diabetes mellitus were significantly more likely (p <0.05) to develop pyelonephritis than those who did not have diabetes.Conclusion. The most common reasons for the urgent hospital attendance of patients with nephrostomy drainage are pyelonephritis and inadequate function. Diabetes mellitus is a risk factor for the development of pyelonephritis in this group of patients.