Predictive value of CT scan in the outcome of renal function in patients with acute obstructive renal failure / 中华泌尿外科杂志

ABSTRACT

Objective To evaluate the predictive value of CT scan in the outcome of renal function after decompression procedures in patients with acute obstructive renal failure.Methods Retrospective analysis of clinical information of 76 patients with acute obstructive renal failure between January 2012 and August 2017 was performed.Clinical information included age,cause of obstruction,type of decompression procedures,total renal area and dominant side renal area measured by CT scan,serum creatinine(SCr) level before operation,SCr level in 3 months after decompression.Patients were divided into 2 groups according to creatinine clearance rate (CCr) in 3 months after decompression,including normal renal function group (26 cases,CCr ≥50 ml/min) and decompensated renal function group (50 cases,CCr ＜ 50 ml/min).The CCr of normal renal function group was (65.3 ± 12.8)ml/min,while the decompensated renal function group was (28.9 ± 11.9)ml/min.The average age of normal renal function group was 48.3 years old,the median value of serum creatinine before operation was 633μmol/L,while the average age of decompensated group was 63.8 years old,the median value of preoperative creatinine was 583 μmol/L.Renal area was measured in CT scan image which was performed when acute obstructive renal failure was diagnosed.Univariate analysis and logistic regression multivariate analysis was used to analyze these parameters.Receiver operating characteristic curve (ROC) was used to evaluate the performance of CT scan for renal function prediction.Results There were significant differences in the renal area between the normal renal function and decompensated renal function group,the total renal area were (3 765.5 ± 628.6) mm2 (range 2 375.3-4 853.6 mm2) and (2 493.0 ± 830.6) mm2 (range 476.9-4 225.1 mm2) respectively (P ＜ 0.001),while the dominant side renal area were (2 283.5 ± 430.2) mm2 (range 1 654.6-3 383.3 mm2) and (1 655.5 ± 496.2) mm2 (range 476.94-2 816.0 mm2) respectively (P ＜ 0.001).The integration area under the ROC curve of the total renal area to predict the outcome of renal function was 0.89.Conclusions The renal area measured in CT scan image might be useful for the early prediction of renal function outcome in patients with acute obstructive renal failure.