The recovery of affected side kidney function after upper urinary tract obstruction was relieved, a retrospective study / 中华泌尿外科杂志

ABSTRACT

Objective To investigate the recovery of affected side kidney function after upper urinary tract obstruction was relieved Methods 78 patients who had been diagnosed with upper urinary tract obstruction were enrolled from January to December of 2015 in our hospital.All patients received the surgery to relieve the obstruction.GFR of the affected side kidney was done after one months of the surgery.The average age was(51.3 ± 12.8)years old.The reason of obstruction was upper urinary tract calculi (72 cases) and upper urinary tract stenosis (6 cases) respectively.All the patients received CT and ECT before and after operation.All the patients was divided into 3 groups by the decreased degree of affected side kidney function,including moderately decreased group [15 rnl/min ≤ GFR ＜ 30 ml/min,n =43,mean value =(23.1 ±5.0) mL/min],severely decreased group [7.5 rnL/min≤ GFR ＜ 15 ml/min,n =23,mean value =(11.2 ± 2.3) ml/min],and extreme severely decreased group [GFR ＜ 7.5 ml/min,n =12,mean value =(4.3 ± 2.9)ml/min].Linear correlation analysis was used to analysis the relationship analysis between the GFR value (pre-operation,post-operation) and the renal cortical thickness.The follow up time of extreme severely decreased group extended to 8-12 months.Results The GFR of moderate decreased group recovered to(30.6 ± 8.5) ml/min,regained averagely (7.56 ± 7.62) ml/min;the severely decreased group recovered to (13.1 ± 4.5) ml/min,regain (1.94 ± 3.38) ml/min.Extreme severely decreased group recovered to (11.1 ± 3.4) ml/min,regained averagely (6.75 ± 4.76) rnl/min,the GFR mean value after operation 8-12 months recovered to (12.7 ± 3.6) ml/min.All groups got significant recovery of kidney function of the affected side.The correlation coefficient between GFR value and the renal cortical thickness was 0.59 (before the surgery) and 0.70 (after the surgery) respectively (P ＜ 0.05).Conclusions Most of affected side kidneys got different degree of recovery.Obstruction influenced the accuracy of ECT at the time of evaluating the actual renal function before operation.The kidneys which had been supposed should be resected in presurgical evaluation could recover to the level of kidney reserve after the surgery.