| Title |
Dializuojamų ligonių šlapimo takų ligų chirurginis gydymas / |
| Translation of Title |
Surgical treatment of urinary tract in haemodialysed patients. |
| Authors |
Ramonas, Henrikas ; Kantaravičienė, Asta ; Rimas, Audrius |
| DOI |
10.15388/LietChirur.2005.4.2296 |
| Full Text |
|
| Is Part of |
Lietuvos chirurgija.. Vilnius : Vilniaus universiteto leidykla. 2005, t. 3, Nr. 4, p. 305-311.. ISSN 1392-0995. eISSN 1648-9942 |
| Keywords [eng] |
haemodialysis ; renal failure ; nephrectomy ; obstructive uropathy ; infravesical obstruction |
| Abstract [eng] |
To evaluate the influence of urinary tract changes on renal functional recovery when drainage of the upper urinary tract is performed in the case of ureteric obstruction and severe renal impairment, looking for options of more optimal postoperative therapy. Patients and methods In 60 consecutive patients with upper urinary tract obstruction and severe renal impairment, treated in the urological department from 1999 until 2004, a retrospective analysis of treatment cases was done. Statistical analysis of preoperative functional and morphological changes of the urinary tract, evaluation of their influence on postoperative renal functional recovery was done. Results The patients’ age was 66.38 ± 1.54 years. Bilateral obstruction was found in 35 (58.33%), solitary kidney obstruction in 25 (41.67%) patients. Percutaneous nephrostomy was performed in 48 (80.0%), operative nephrostomy in 5 (8.33%), ureteric stenting in 7 (11.67%) cases. Palliative kidney drainage was employed for 31 (51,67%) patients. In the patients in whom obstruction development was clinically defined as rapid, the mean plasma creatinine concentration after treatment was lower in comparison with chronic obstruction, reaching respectively 240.48 ± 25.7 mmol/l and 395.83 ± 22.3 mmol/l (p < 0.05). A positive correlation was found among renal cortical thickness and daily postoperative creatinine level decrease, especially in cases of nephrolithiasis (r = 0.55). When bilateral obstruction was diagnosed in 31 oncological patients, unilateral nephrostomy was a sufficient treatment option in 27 (87.1%) cases. Conclusions Drainage of the obstructed upper urinary tract influences renal functional recovery in all cases. In clinically defined rapid obstruction cases, renal functional recovery is better in comparison with chronic obstruction. Renal functional recovery postively corellated with renal cortical thickness. |
| Published |
Vilnius : Vilniaus universiteto leidykla |
| Type |
Journal article |
| Language |
Lithuanian |
| Publication date |
2005 |
| CC license |
|
