Letter to Editor
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The Overlooked Role of Postrenal Causes in Acute Renal Failure: A Urological Perspective

Year 2025, Volume: 7 Issue: 3, 59 - 61, 31.12.2025
https://doi.org/10.55994/ejcc.1790221

Abstract

This letter to the editor provides a urological perspective on a recent study investigating gender-related biochemical parameters in acute renal failure (ARF). ARF is traditionally classified as prerenal, intrinsic renal, or postrenal. While most studies emphasize prerenal and intrinsic etiologies, postrenal causes represent a clinically significant and often reversible subset, particularly in elderly men. Common etiologies include benign prostatic hyperplasia, prostate cancer, bladder tumors, ureteral calculi, and strictures. In this context, elevated serum creatinine levels in men may not only reflect differences in muscle mass but also a higher burden of obstructive pathology. Timely diagnosis with imaging and prompt decompression procedures can lead to full recovery of renal function in postrenal ARF. Therefore, systematic evaluation for obstructive causes should be an integral part of the diagnostic approach, especially in elderly male patients.

References

  • Demir B, Dolanbay T, Nogay S, Tan F, Öngenli ÖF. Investigation of the Effect of Gender on Blood Parameters in Acute Renal Failure in Patients Presenting to the Emergency Department of a Hospital. Eurasian j Crit Care. September 2025;7(2):7-12.
  • Kellum JA, Lameire N; KDIGO AKI Guideline Work Group. Diagnosis, evaluation, and management of acute kidney injury: a KDIGO summary (Part 1). Crit Care. 2013 Feb 4;17(1):204. doi: 10.1186/cc11454. PMID: 23394211; PMCID: PMC4057151.
  • Erbatu O, Müezzinoğlu T. Obstructive Uropathy in Advanced Prostate Cancer. Bull Urooncol. 2023 Jun 12;22(2):57-61. doi: 10.4274/uob.galenos.2022.2022.10.6.
  • Özdemir S, Kokulu K. Sports-Related High-Grade Renal Injury: A Case Report. Eurasian j Crit Care. April 2022;4(1):24-25. doi:10.55994/ejcc.1019890
  • Kemec Z, Tüzün C, Gürel A. Neurogenic Bladder and Acute Kidney Injury in Leukodystrophy. Cureus. 2020 Jun 20;12(6):e8707. doi: 10.7759/cureus.8707. PMID: 32699703; PMCID: PMC7372234.
  • Acem B, Eroğlu SE, Özdemir S. Impact of delta troponin on short-term mortality in patients with chronic renal dysfunction and NSTEMI. Ibnosina J Med Biomed Sci. 2024;16(2):86-91.
  • Özdemir S. Re: A case of acute renal failure requiring emergency hemodialysis due to hypothermia-associated rhabdomyolysis. J Surg Med. January 2022;6(1):82-83. doi:10.28982/josam.953596
  • Skolarikos A, Geraghty R, Somani B, Tailly T, Jung H, Neisius A, Petřík A, Kamphuis GM, Davis N, Bezuidenhout C, Lardas M, Gambaro G, Sayer JA, Lombardo R, Tzelves L. European Association of Urology Guidelines on the Diagnosis and Treatment of Urolithiasis. Eur Urol. 2025 Jul;88(1):64-75. doi: 10.1016/j.eururo.2025.03.011. Epub 2025 Apr 22. PMID: 40268592.
  • Taleb Abdellah A, Koratala A. Nephrologist-Performed Point-of-Care Ultrasound in Acute Kidney Injury: Beyond Hydronephrosis. Kidney Int Rep. 2022 Mar 4;7(6):1428-1432. doi: 10.1016/j.ekir.2022.02.017. PMID: 35685325; PMCID: PMC9171614.
  • Cronin CG, Lohan DG, Blake MA, Roche C, McCarthy P, Murphy JM. Retroperitoneal fibrosis: a review of clinical features and imaging findings. AJR Am J Roentgenol. 2008 Aug;191(2):423-31. doi: 10.2214/AJR.07.3629. PMID: 18647912.
  • Abdel-Kader K, Palevsky PM. Acute kidney injury in the elderly. Clin Geriatr Med. 2009 Aug;25(3):331-58. doi: 10.1016/j.cger.2009.04.001. PMID: 19765485; PMCID: PMC2748997.
  • Medina JJ, Parra RO, Moore RG. Benign prostatic hyperplasia (the aging prostate). Med Clin North Am. 1999 Sep;83(5):1213-29. doi: 10.1016/s0025-7125(05)70159-0. PMID: 10503061.
  • Gaudreau-Simard M, Ruller S, Dann M, Woo MY, Mallick R, Mcinnes MDF, Clark EG, Evans J. Imaging of Medical Patients with Acute Kidney Injury: Patterns of Ultrasound Use and the Role of Point-of-care Ultrasound at a Tertiary Care Center. J Gen Intern Med. 2025 Jul 9. doi: 10.1007/s11606-025-09704-2. Epub ahead of print. PMID: 40634652.
  • Gaudreau-Simard M, Ruller S, Dann M, Woo MY, Mallick R, Mcinnes MDF, Clark EG, Evans J. Imaging of Medical Patients with Acute Kidney Injury: Patterns of Ultrasound Use and the Role of Point-of-care Ultrasound at a Tertiary Care Center. J Gen Intern Med. 2025 Jul 9. doi: 10.1007/s11606-025-09704-2. Epub ahead of print. PMID: 40634652.

Akut Böbrek Yetmezliğinde Postrenal Nedenlerin Göz Ardı Edilen Rolü: Ürolojik Bir Bakış Açısı

Year 2025, Volume: 7 Issue: 3, 59 - 61, 31.12.2025
https://doi.org/10.55994/ejcc.1790221

Abstract

Bu editöryel mektupta, akut böbrek yetmezliğinde (ABY) cinsiyet farklılıklarına ilişkin biyokimyasal parametreleri inceleyen güncel bir çalışmaya ürolojik açıdan katkı sunulmaktadır. ABY’nin prerenal, intrarenal ve postrenal nedenlerle sınıflandırıldığı bilinmektedir. Literatürde genellikle prerenal ve intrarenal nedenler ön plana çıkmakla birlikte, postrenal nedenler özellikle ileri yaş ve erkek hastalarda önemli ve çoğu zaman geri dönüşümlü bir etiyolojiyi temsil etmektedir. Benign prostat hiperplazisi, prostat kanseri, mesane tümörleri, üreter taşları ve striktürler postrenal ABY’nin başlıca nedenleridir. Bu bağlamda erkeklerde kreatinin yüksekliğinin yalnızca kas kütlesine değil, aynı zamanda obstrüktif üropatiye de bağlı olabileceği vurgulanmaktadır. Erken tanı ve hızlı dekompresyon yöntemleri sayesinde postrenal ABY’de böbrek fonksiyonları tamamen geri kazanılabilir. Bu nedenle, özellikle yaşlı erkek hastalarda postrenal nedenlerin değerlendirilmesi tanısal yaklaşımın ayrılmaz bir parçası olmalıdır.

References

  • Demir B, Dolanbay T, Nogay S, Tan F, Öngenli ÖF. Investigation of the Effect of Gender on Blood Parameters in Acute Renal Failure in Patients Presenting to the Emergency Department of a Hospital. Eurasian j Crit Care. September 2025;7(2):7-12.
  • Kellum JA, Lameire N; KDIGO AKI Guideline Work Group. Diagnosis, evaluation, and management of acute kidney injury: a KDIGO summary (Part 1). Crit Care. 2013 Feb 4;17(1):204. doi: 10.1186/cc11454. PMID: 23394211; PMCID: PMC4057151.
  • Erbatu O, Müezzinoğlu T. Obstructive Uropathy in Advanced Prostate Cancer. Bull Urooncol. 2023 Jun 12;22(2):57-61. doi: 10.4274/uob.galenos.2022.2022.10.6.
  • Özdemir S, Kokulu K. Sports-Related High-Grade Renal Injury: A Case Report. Eurasian j Crit Care. April 2022;4(1):24-25. doi:10.55994/ejcc.1019890
  • Kemec Z, Tüzün C, Gürel A. Neurogenic Bladder and Acute Kidney Injury in Leukodystrophy. Cureus. 2020 Jun 20;12(6):e8707. doi: 10.7759/cureus.8707. PMID: 32699703; PMCID: PMC7372234.
  • Acem B, Eroğlu SE, Özdemir S. Impact of delta troponin on short-term mortality in patients with chronic renal dysfunction and NSTEMI. Ibnosina J Med Biomed Sci. 2024;16(2):86-91.
  • Özdemir S. Re: A case of acute renal failure requiring emergency hemodialysis due to hypothermia-associated rhabdomyolysis. J Surg Med. January 2022;6(1):82-83. doi:10.28982/josam.953596
  • Skolarikos A, Geraghty R, Somani B, Tailly T, Jung H, Neisius A, Petřík A, Kamphuis GM, Davis N, Bezuidenhout C, Lardas M, Gambaro G, Sayer JA, Lombardo R, Tzelves L. European Association of Urology Guidelines on the Diagnosis and Treatment of Urolithiasis. Eur Urol. 2025 Jul;88(1):64-75. doi: 10.1016/j.eururo.2025.03.011. Epub 2025 Apr 22. PMID: 40268592.
  • Taleb Abdellah A, Koratala A. Nephrologist-Performed Point-of-Care Ultrasound in Acute Kidney Injury: Beyond Hydronephrosis. Kidney Int Rep. 2022 Mar 4;7(6):1428-1432. doi: 10.1016/j.ekir.2022.02.017. PMID: 35685325; PMCID: PMC9171614.
  • Cronin CG, Lohan DG, Blake MA, Roche C, McCarthy P, Murphy JM. Retroperitoneal fibrosis: a review of clinical features and imaging findings. AJR Am J Roentgenol. 2008 Aug;191(2):423-31. doi: 10.2214/AJR.07.3629. PMID: 18647912.
  • Abdel-Kader K, Palevsky PM. Acute kidney injury in the elderly. Clin Geriatr Med. 2009 Aug;25(3):331-58. doi: 10.1016/j.cger.2009.04.001. PMID: 19765485; PMCID: PMC2748997.
  • Medina JJ, Parra RO, Moore RG. Benign prostatic hyperplasia (the aging prostate). Med Clin North Am. 1999 Sep;83(5):1213-29. doi: 10.1016/s0025-7125(05)70159-0. PMID: 10503061.
  • Gaudreau-Simard M, Ruller S, Dann M, Woo MY, Mallick R, Mcinnes MDF, Clark EG, Evans J. Imaging of Medical Patients with Acute Kidney Injury: Patterns of Ultrasound Use and the Role of Point-of-care Ultrasound at a Tertiary Care Center. J Gen Intern Med. 2025 Jul 9. doi: 10.1007/s11606-025-09704-2. Epub ahead of print. PMID: 40634652.
  • Gaudreau-Simard M, Ruller S, Dann M, Woo MY, Mallick R, Mcinnes MDF, Clark EG, Evans J. Imaging of Medical Patients with Acute Kidney Injury: Patterns of Ultrasound Use and the Role of Point-of-care Ultrasound at a Tertiary Care Center. J Gen Intern Med. 2025 Jul 9. doi: 10.1007/s11606-025-09704-2. Epub ahead of print. PMID: 40634652.
There are 14 citations in total.

Details

Primary Language English
Subjects Emergency Medicine
Journal Section Letter to Editor
Authors

Erkan Arslan 0000-0002-3262-2512

Submission Date September 24, 2025
Acceptance Date October 15, 2025
Publication Date December 31, 2025
Published in Issue Year 2025 Volume: 7 Issue: 3

Cite

AMA Arslan E. The Overlooked Role of Postrenal Causes in Acute Renal Failure: A Urological Perspective. Eurasian j Crit Care. December 2025;7(3):59-61. doi:10.55994/ejcc.1790221