Prevalence and risk factors of post obstructive diuresis afterpercutaneous nephrostomy in obstructive nephropathy patients
Keywords:post obstructive diuresis, obstructive uropathy, risk factor
Objective: To identify the prevalence and risk factors of post-obstructive diuresis after percutaneous nephrostomy in obstructive nephropathy patients who have functional or anatomic renal damage from urinary tract obstruction.
Material and methods: Between October 2011 and November 2014, obstructive nephropathy patients who had hydronephrosis, diagnosed by ultrasound or CT scan, acute kidney injury from blood test and underwent percutaneous nephrostomy at Rajavithi Hospital were enrolled in this retrospective study. Patient demographics, kidney characteristics, clinical and laboratory values were collected at the time of admission and analyzed for risk factors of post obstructive diuresis using univariate and multivariate analysis.
Results: Of 305 patients with obstructive uropathy, 229 patients were eligible for inclusion based on our eligibility criteria. Of 229 patients included, 142 had complete data available. Post obstructive diuresis occurred in 61 of the 142 (43%) patients. Single kidney (OR 6.13, 95% CI 1.48-25.32, p=0.012) and low glomerular filtration rate (GFR) (OR 0.94, 95% CI 0.90-0.98, p=0.005) independently predicted post obstructive diuresis after multivariate analysis.
Conclusion: Prevalence of post obstructive diuresis was about 43%. Our study demonstrated that single kidney and low GFR are risk factors for post obstructive diuresis. However, a large prospective study is required to further investigate these findings.
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