Serum creatinine trajectory after drainage of kidneys with bilateral malignant ureteral obstruction: a prospective non-randomized comparative study.

Autor: Gadelkareem RA; Assiut Urology and Nephrology Hospital, Faculty of Medicine, Assiut University, Elgamaa Street, Assiut, 71515, Egypt. dr.rabeagad@yahoo.com., Abdelraouf AM; Assiut Urology and Nephrology Hospital, Faculty of Medicine, Assiut University, Elgamaa Street, Assiut, 71515, Egypt., El-Taher AM; Assiut Urology and Nephrology Hospital, Faculty of Medicine, Assiut University, Elgamaa Street, Assiut, 71515, Egypt., Ahmed AI; Assiut Urology and Nephrology Hospital, Faculty of Medicine, Assiut University, Elgamaa Street, Assiut, 71515, Egypt., Shalaby MM; Assiut Urology and Nephrology Hospital, Faculty of Medicine, Assiut University, Elgamaa Street, Assiut, 71515, Egypt.
Jazyk: angličtina
Zdroj: BMC urology [BMC Urol] 2023 Feb 22; Vol. 23 (1), pp. 24. Date of Electronic Publication: 2023 Feb 22.
DOI: 10.1186/s12894-023-01188-8
Abstrakt: Background: Serum creatinine trajectory (SCr-Tr) is a neglected prognostic tool for chronic and acute kidney injury. We aimed to assess the predictors of SCr-Tr during the time-to-nadir and serum creatinine (SCr) normalization rate after drainage, using percutaneous nephrostomy in patients with bilateral malignant ureteral obstruction.
Methods: A prospective non-randomized study was performed on SCr-Tr in patients with bilateral malignant ureteral obstruction from August 2019 to March 2022. The primary outcome was SCr-Tr during the time-to-nadir.
Results: This study included 102 patients with a mean age ± SD of 59.6 ± 14.7 years. SCr-Tr was non-linear with a mean ± SD (range) of 0.5 ± 0.4 (0.03-2.3) mg/dl/day. Multivariate analyses revealed that female gender (p = 0.016), body mass index (BMI; p = 0.005), and SCr at presentation (p < 0.001) were predictors of rapid SCr-Tr during the time-to-nadir. However, age (p = 0.008) and low urine output at presentation (p = 0.015) were associated with a lower SCr-Tr. In contrast, laterality of drainage (p = 0.544) and mean parenchymal thickness (p = 0.066) were not associated with mean SCr-Tr. Also, only the mean parenchymal thickness (p = 0.002) was a predictor of rapid SCr-Tr at ≥ 0.5 mg/dl/day. However, low BMI (p = 0.023) was associated with a high SCr normalization rate, while unilateral drainage (p = 0.045) was associated with a lower rate.
Conclusions: Female gender, low BMI, and SCr at presentation were predictors of rapid SCr-Tr during the time-to-nadir. Bilateral drainage was an independent predictor of SCr normalization rate, but not of rapid SCr-Tr. The mean parenchymal thickness was the only independent predictor for rapid SCr-Tr at ≥ 0.5 mg/dl/day.
(© 2023. The Author(s).)
Databáze: MEDLINE
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