Irreversible Renal Function Impairment Due to Silent Ureteral Stones

OBJECTIVE To evaluate if renal function loss and hydronephrosis due to a silent ureteral stone might be reversed. MATERIALS AND METHODS We prospectively selected patients with silent ureteral stones between January 2006 and January 2014. A silent case was considered if there were no specific or subjective symptoms related to the ureteral stone. Patient, stone, and kidney characteristics were evaluated preoperatively, 3 and 12 months postoperatively. Renal function was accessed in the same intervals with serum creatinine (SCr), glomerular filtration rate (GFR), and Tc-99m-dimercaptosuccinic acid. Patients without complete pre-and postoperative evaluation were excluded. Primary end point was midterm progress of global and ipsilateral renal function. Secondary end points included the evaluation of renal and collecting system anatomy from diagnosis to 12 months after treatment. Analysis of variance with repeated measures and marginal homogeneity test were used to evaluate renal function and hydronephrosis progression. RESULTS Twenty-six patients met our inclusion criteria. Mean preoperative SCr and GFR were 1.24 mg/dL and 72.5 mL/min, respectively. At initial scintigraphy, mean renal function was 33.4%. Laser ureterolithotripsy was performed in 84.6% of cases and all patients were rendered stone free. Two patients (8%) developed ureteral stenosis. There was no difference regarding SCr (P =.89), GFR (P =.48), and renal function at scintigraphy (P =.19) during follow-up. Hydronephrosis significantly improved from preoperatively to 3 months postoperatively (P < .0001), but not from 3 to 12 months (P =.065). CONCLUSION Patients with silent ureteral stones present with significant impairment of ipsilateral renal function and hydronephrosis at diagnosis. On midterm follow-up evaluation, renal function of the affected unit remains stable whereas hydronephrosis improves after treatment. (C) 2016 Elsevier Inc.

URI

https://observatorio.fm.usp.br/handle/OPI/16048

Referências

ANDRENSANDBERG A, 1983, SCAND J UROL NEPHROL, V17, P81
Beiko Darren T, 2003, Can J Urol, V10, P2062
Dropkin BM, 2015, J UROLOGY, V193, P1265, DOI 10.1016/j.juro.2014.11.056
Earlam R J, 1967, Br J Urol, V39, P58
FEDULLO LM, 1988, AM J ROENTGENOL, V151, P1145
Fielding JR, 1997, J UROLOGY, V157, P2071, DOI 10.1016/S0022-5347(01)64676-7
Gandolpho L, 2001, BRAZ J MED BIOL RES, V34, P745, DOI 10.1590/S0100-879X2001000600007
German I, 2002, EUR UROL, V42, P188, DOI 10.1016/S0302-2838(02)00271-3
GLOWACKI LS, 1992, J UROLOGY, V147, P319
GRAHAM JB, 1962, JAMA-J AM MED ASSOC, V181, P993
HARDY MR, 1987, J UROLOGY, V137, P91
Irving SO, 2000, BJU INT, V85, P637, DOI 10.1046/j.1464-410x.2000.00563.x
Karadag MA, 2008, J ENDOUROL, V22, P261, DOI 10.1089/end.2006.0445
Keeley FX, 2001, BJU INT, V87, P1, DOI 10.1046/j.1464-410x.2001.00781.x
KELLEHER JP, 1991, BRIT J UROL, V67, P125, DOI 10.1111/j.1464-410X.1991.tb15092.x
LEWIS HY, 1962, J UROLOGY, V88, P377
LUPTON EW, 1992, J UROLOGY, V147, P981
MAHMOUD AH, 1991, CLIN NUCL MED, V16, P162, DOI 10.1097/00003072-199103000-00005
Marchini GS, 2012, UROLOGY, V79, P304, DOI 10.1016/j.urology.2011.07.1436
Okubo K, 1998, J UROLOGY, V160, P1422, DOI 10.1016/S0022-5347(01)62557-6
Preminger GM, 2007, J UROLOGY, V178, P2418, DOI 10.1016/j.juro.2007.09.107
Romero Victoriano, 2010, Rev Urol, V12, pe86
Scales CD, 2012, EUR UROL, V62, P160, DOI 10.1016/j.eururo.2012.03.052
Stamatelou KK, 2003, KIDNEY INT, V63, P1817, DOI 10.1046/j.1523-1755.2003.00917.x
Streem SB, 1996, J UROLOGY, V155, P1186, DOI 10.1016/S0022-5347(01)66208-6
Taylor EN, 2005, JAMA-J AM MED ASSOC, V293, P455, DOI 10.1001/jama.293.4.455
Weizer AZ, 2002, J UROLOGY, V168, P46, DOI 10.1016/S0022-5347(05)64829-X
Williams JC, 2004, J ENDOUROL, V18, P937, DOI 10.1089/end.2004.18.937
Wimpissinger F, 2014, BMC UROL, V14, DOI 10.1186/1471-2490-14-3
Wimpissinger F, 2007, J UROLOGY, V178, P1341, DOI 10.1016/j.juro.2007.05.128

Coleções

Artigos e Materiais de Revistas Científicas - FM/MCG
Artigos e Materiais de Revistas Científicas - HC/ICHC
Artigos e Materiais de Revistas Científicas - LIM/55

Página do item completo