https://doi.org/10.4081/aiua.2021.2.178

Time dependant functional and morphological recovery of the kidney after relief of obstruction in patients with impacted ureteral stones

Vol. 93 No. 2 (2021)
Submitted: April 21, 2021
Accepted: May 2, 2021
Published: June 28, 2021
Impacted ureteral stones, Renal function, Morphology, JJ stent, Obstruction
Abstract Views: 1285
PDF: 599
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Authors

Hüseyin Kocatürk
kocaturk78@hotmail.com
Department of Urology Health Sciences University, Erzurum Regional Training and Research Hospital, Erzurum, Turkey.
Fevzi Bedir
Department of Urology Health Sciences University, Erzurum Regional Training and Research Hospital, Erzurum, Turkey.
Ömer Turangezli
Department of Urology Health Sciences University, Erzurum Regional Training and Research Hospital, Erzurum, Turkey.
Engin Şebin
Department of Biochemistry Health Sciences University, Erzurum Regional Training and Research Hospital, Erzurum, Turkey.
Mehmet Sefa Altay
Department of Urology Health Sciences University, Erzurum Regional Training and Research Hospital, Erzurum, Turkey.
Banu Bedir
Aziziye District Health Directorate, Erzurum, Turkey.
Kemal Sarıca
Biruni University, Faculty of Medicine, Department of Urology, Istanbul, Turkey.

Objectives: To assess the course of functional and morphological recovery of the kidney following the relief of obstruction with ureteral JJ stent in cases with unilateral impacted stones.
Materials and methods: A total of 42 adult patients who were admitted to our clinic with unilateral obstructing impacted ureteral stones requiring JJ stent placement were included in the study. The course of functional recovery was assessed by evaluating the serum creatinine levels, renal resistive index (RRI) values and urinary levels of kidney injury molecule-1, neutrophil gelatinaseassociated lipocalin as well as microalbumin before at 1 day, 1 week and 4 weeks after JJ stent placement. Course of morphologic recovery was evaluated by evaluating the degree of hydronephrosis, kidney size, perirenal straining and ureteral diameter.
Results: Our results showed that all relevant parameters began to decrease after 24 hours and continue to normalize during 1 week evaluation; majority of these variables indicating the functional and morphological recovery were in normal range after 4 weeks. Decompression of the obstructed kidneys with JJ stent placement in patients with impacted ureteral stones was found to be effective enough with recovery of normal renal functional and morphological status after a minimum time period of 4 weeks. Morphological recovery of affected kidneys following JJ stenting was obtained with a significant difference between baseline and 1-month evaluation findings (p = 0.001, p < 001, p < 001, respectively). KIM-1 excretion began to decline to normal levels after 4 weeks (3.52 ± 0.99 ng/ml versus 2.84 ± 0.66 ng/ml, p < 0.001). The same findings were observed for the urinary excretion levels of NGAL, which normalized at the 1-month evaluation (604.55 ± 140.28 ng/ml versus 596.87 ± 80.17 ng/ml p = 0.895). Urinary microalbumin excretion levels however remained high even until 1-month follow-up with a statistically significant difference when compared with the normal excretion values (p < 0.001). There was a statistically significant difference in RRI values between baseline and 1-month follow-up findings in obstructed kidney (p < 0.001).
Conclusions: Elective management of the obstructing impacted ureteral stone(s) will be safer with limited risk of infective complications after functional and morphological normalization in such kidneys following 4 weeks of JJ stent placement.

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How to Cite

Kocatürk, H., Bedir, F., Turangezli, Ömer, Şebin, E., Altay, M. S., Bedir, B., & Sarıca, K. (2021). Time dependant functional and morphological recovery of the kidney after relief of obstruction in patients with impacted ureteral stones. Archivio Italiano Di Urologia E Andrologia, 93(2), 178–183. https://doi.org/10.4081/aiua.2021.2.178

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