Prediction of the recovery of renal function for patients that have obstructive renal failure. A longitudinal study

Abstract

Aim: The study aimed to predict the future recovery of renal function for patients that have obstructive renal failure.

Study design: A longitudinal study

Place and Duration: This study was conducted at Pakistan Institute of Medical Sciences Islamabad, Pakistan from January 2020 to January 2021.

Methodology: In the study, 239 patients were involved. These patients had renal as well as ureteric calculi that generally go hand in hand with renal failure. The patients were evaluated to check for the potential for recovery before definitive surgery. In every patient, ultrasonography was done preoperatively. Afterward, (PCN) percutaneous nephrostomy, was carried out as part of initial management before any definitive surgery took place. A total of 125 patients had their DTPA scan, (Diethylene triamine penta acetic acid), carried out after percutaneous nephrostomy. With the help of serum creatinine, the results of the pre-operative DTPA scans were compared with postoperative drop. Urine Na’, creatinine clearance, urine pH, serum creatinine, and initial diuresis were all measured one after the other after twenty-four hours and then weekly for six weeks. Three months after the surgery, serum creatinine was used to re-evaluate patients. To predict the recovery in the future, ultrasonography was used.

Results: The findings showed that in 76.5% of the cases, there was a recovery in renal functions, and in 81.9% of cases the DTPA scan showed true obstruction of shorter duration.

Conclusion: Good prognostic indicators include 6 or less pH level of urine, natriuresis, and post-PCN diuresis. The study showed PCN is the most reliable approach for the prediction of future recovery of renal function.