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Predictors of time-to-nadir serum creatinine after drainage of bilaterally obstructed kidneys due to bladder cancer

当代泌尿学（英文） 2023年第4期17卷 246-250页

作者： Rabea Ahmed Gadelkareem Ahmed mahmoud Abdelraouf Abdelfattah Ibrahim Ahmed Ahmed Mohammed El-Taher hosny mahmoud behnsawy Assiut Urology and Nephrology Hospital Faculty of MedicineAssiut UniversityAssiutEgypt

Background:There are persistent controversies about the outcomes and benefits of drainage of malignant ureteral obstruction by per-cutaneous nephrostomy(PCN).This study aimed to assess the predictors of the time-to-nadir(TTN)of serum creatinine(SCr)levels after drainage of bilaterally obstructed kidneys(BOKs)due to bladder cancer(BC)by PCN.Materials and methods:This prospective nonrandomized study included patients with BOKs due to BC treated by PCN between April 2019 and March *** primary outcome measure was TTN.Results:Of the 55 patients with a median age(range)of 66 years(47-86 years),32(58.2％)had a normal nadir SCr and 23(41.8％)had a high nadir SCr within 21 days after drainage of BOKs due to *** nadir SCr was associated with a higher mean age(p=0.011)and lower body mass index(BMI,p=0.043).However,patients with normal nadir SCr had a significantly shorter TTN(p=0.023)and an increased mean SCr trajectory(p＜0.001)during *** multivariate analysis,low urine output at presentation(p=0.021)and high BMI(p=0.006)were associated with longer ***,the mean parenchymal thickness(p=0.428)and laterality of drainage(p=0.466)were not associated with the mean TTN and SCr normalization *** to the modified Clavien-Dindo classification,8 cases of hematuria were managed conservatively(grade 2),and 2 cases of PCN slippage were repositioned using local anesthesia(grade 3).Conclusions:Despite the safety of PCN for drainage of BOKs due to BC,more than 41％of the patients failed to have a normal nadir *** low urine output and high BMI were associated with longer *** of drainage had no significant effects on the TTN and SCr trajectory.

关键词： Bilaterally obstructed kidneys Bladder cancer Malignant ureteral obstruction Percutaneous nephrostomy Serum creatinine Time-to-nadir

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