Recoverability of Renal Function after Treatment of Adult Patients with Unilateral Obstructive Uropathy: A Prospective Study

Abstract

Background: Obstructive uropathy refers to any blockage of urine drainage at any level of the urinary tract. It may be chronic or acute and may occur unilateral or bilateral. The prediction of the recoverability of kidney function after treatment of unilateral obstructive uropathy is of great clinical value to the urologists and nephrologists as it may affect the decision of treatment. Objectives: To detect changes in split renal function of unilaterally obstructed kidney after a period of 6 weeks of drainage. Patients and methods: This prospective observational study included 66 adult patients divided into 2 groups; Group A included patients with split function less than 10 % (36 patients) and Group B included patients with split function of 10 % or more (30 patients). Results: The study showed that there were an insignificant difference between the two groups in age, sex, cause of obstruction, laterality of obstruction, method of drainage and patient’s presentation. Also, there was an insignificant difference between pre- and post-drainage for group A (P-value 0.142). While there was a highly significance difference between pre- and post-drainage for group B (P-value < 0.001). Conclusion: the preoperative split function of the obstructed kidney is the independent factor affecting the recoverability of renal function. Where kidneys with split function less than 10% are irreversibly damaged and the decision of treatment can be taken with no need to do drainage followed by repeating renal scan. While stabilization or improvement of renal function is expected after relief of obstruction in kidneys with split function of 10% or greater.