The most common cause of non-functioning kidney nephrectomy: Urolithiasis

Year 2014, Volume: 41 Issue: 3, 491 - 494, 01.09.2014

Şenol Adanur Tevfik Ziypak Mahmut Koç Erdem Koç Turgut Yapanoğlu İsa Özbey Özkan Polat

https://doi.org/10.5798/diclemedj.0921.2014.03.0460

Abstract

Objective: Our aim is to evaluate and present the characteristics of patients underwent nephrectomy due to non-functional kidney secondary to urolithiasis in our clinic. Methods: Totally 696 patients were anlyzed retrospectively who underwent nephrectomy in our clinic between January 2000 and December 2012. Etiologies and characteristics of nephrectomy applied patients due to non-tumoral non-functional kidney related with urinary tract stones are evaluated. Diagnoses of the patients were confirmed by using urinary system ultrasonography, abdominal computed tomography, intravenous urography and renal scintigraphy. Results: Nephrectomy was performed for 280 (40.2%) patients due to tumor formation and for 416 (59.8%) patients due to non-functional kidney of totally 696 patients. 43.8% (182) of non-funtional kidney cases were resulted by upper urinary tract stones. Mean age of nephrectomy performed urolithiasis patients were 43.7±16.9 years. 53.3% (97) of patients were male and 46.7% (85) patients were female. Preoperative mean creatinine value of patients were detected 2.98±0.47 mg/dl. Renal stone localizatian was ureteropelvic junction in 81.3% (148), ureter in 14.3% (26) and renal+ureter in 4.4% (8) of the patients. 66.8% of ureteropelvic junction stones were 10-30 mm in size. Conclusion: Upper urinary tract stones are primer responsible of non-functional kidney development besides forming most of the non-tumor related nephrectomies. Routine urinary system examination should be suggested to patients with a history of urolithiasis in order to prevent later probable organ losses.

Keywords

Urolithiasis, non-functioning kidney, nephrectomy

Nonfonksiyone böbrekte nefrektominin en sık sebebi: Ürolitiyazis

Abstract

Amaç: Kliniğimizde nefrektomi yapılan hastaları değerlendirerek, ürolitiyazise sekonder non-fonksiyone böbreğe bağlı nefrektomi yapılan hastaların karakteristiklerini sunmayı amaçladık. Yöntemler: Ocak 2000- Aralık 2012 tarihleri arasında kliniğimizde nefrektomi yapılan toplam 696 hasta retrospektif olarak incelendi. Tümör dışı, üriner sistem taşına bağlı non-fonksiyone böbrek nedeniyle nefrektomi yapılan hastaların etiyolojileri ve klinik karakteristikleri değerlendirildi. Hastaların tanılarını doğrulamada üriner sistem ultrasonografi, batın bilgisayarlı tomografi, intravenöz ürografi ve renal sintigrafi tetkikleri kullanıldı. Bulgular: Toplam 696 hastanın 280\'i (%40,2) tümör nedeniyle, 416\'sı (%59,8) ise non-fonksiyone böbrek nedeniyle nefrektomi yapıldı. Non-fonksiyone böbrek vakalarının %43,8 (182) ini üst üriner trakt taşları oluşturmaktaydı. Ürolitiyazise bağlı nefrektomi yapılan hastaların yaş ortalaması 43,7±16,9 idi. Hastaların 97\'si (%53,3) erkek, 85\'i (%46,7) bayan idi. Hastaların preoperatif ortalama kreatin değeri 0,98±0,47 mg/dl olarak tespit edildi. Taşlar 148 (%81,3) hastada renal pelviste üreteropelvik bileşkede, 26 (%14,3) hastada üreterde, 8 (%4,4) hastada ise renal+üreter yerleşimli idi. Renal pelviste üreteropelvik bileşkedeki taşların %66,8\'ini 10-30 mm arası taşlar oluşturmakta idi. Sonuçlar: Üst üriner trakt taşları tümör dışı nefrektomilerin büyük bölümünü oluşturmakla birlikte, non-fonksiyone böbrek gelişiminde primer ana faktördür. İleride oluşabilecek muhtemel organ kayıplarını önlemek için ürolitiyazis öyküsü olan hastaların düzenli üriner sistem muayenesi yaptırmaları önerilmelidir.

Keywords

Ürolitiyazis, non-fonksiyone böbrek, nefrektomi

References

• Kavoussi LR, Novick AC, Partin AW, et al. Open surgery of the kidney. In: Wein AJ, Kavoussi LR, Novick AC, Par- tin AW, Peters CA, eds. Campbell-Walsh Urology. 9th ed. Philadelphia: Saunders Elsevier, 2007.
• Robson CJ, Churchill BM, Anderson W. The results of radical nephrectomy for renal cell carcinoma. J Urol 1969;101:297-301.
• Skinner DG, Colvin RB, Vermillion CD, et al. Diagnosis and management of renal cell carcinoma. A clinical and patho- logic study of 309 cases. Cancer 1971; 28:1165-1177.
• Tanagho EA. Urinary obstruction and stasis. In: Tanagho EA, McAninch JW, eds. Smith’s General Urology. 17th ed. New York. The McGraw-Hill Companies, 2008, p 166.
• Kavoussi LR, Novick AC, Partin AW, et al. Pathophysiology of urinary tract obstruction: General issues in management of patients. In: Wein AJ, Kavoussi LR, Novick AC, Par- tin AW, Peters CA, eds. Campbell-Walsh Urology. 9th ed. Philadelphia: Saunders Elsevier, 2007
• Mao S, Jiang H, Wu Z, et al. Urolithiasis: the most risk for nephrectomy in nonrenal tumor patients. J Endourol 2012;26:1356-1360.
• Yasui T, Iguchi M, Suzuki S, et al. Prevalence and epide- miological characteristics of urolithiasis in Japan: National trends between 1965 and 2005. Urology 2008;71:209-213.
• Sandberg K. Mechanisms underlying sex differences in pro- gressive renal disease. Gend Med 2008;5:10-23.
• Silbiger SR, Neugarten J. The impact of gender on the pro- gression of chronic renal disease. Am J Kidney Dis 1995;25:515-533.
• Silbiger S, Neugarten J. Gender and human chronic renal disease. Gend Med 2008; 5(suppl A): S3-S10.