Comparision of efficacy and safety of double j stenting and percutaneous nephrostomy in patients with postrenal acute renal failure due to ureteral obstruction

Abstract

Aim: To compare of efficacy and safety bet- ween percutaneous nephrostomy and ureteral double J stenting in patients with post-renal acute renal failure (ARF).

Material and Methods: A total of 59 patients who presented with post-renal ARF due to ureteral obstruction and who underwent percutaneous nephrostomy or ureteral double j stenting between January 2011 and April 2016 in our clinic were included in this study. Patients were divided into two groups with ureteral double j stents (Group 1) and the other with percutaneous nephrostomy (Group 2). These patients were then evaluated by daily serum urea and creatinine. Patients were compared in terms of creatinine reduction rate, total creatinine change and complications.

Results: There were 40 patients in Group 1 in which renal pelvis drainage performed with ureteral double j stent and 19 patients in Group 2 with percutaneous nephrostomy drainage. Mean follow-up time was 6.8 ± 10.3 days and 7.6 ± 4.0 days for Group 1 and Group 2, respectively. Descrease rate of creatinine was significantly higher in percutaneous nephrostomy group(p<0.001). Decrease of mean creatinine level by daily was 0.31 ± 0.33 and 0.46 ± 0.35 in ureteral double j stent and percutaneous nephrostomy group, respectively(p=0.103). Time to basal creatinine le- vel was similar in both groups. Patients in Group 2 had higher hydronephrosis grades(0.036). Accor- ding to the Clavien-Dindo classification, the two groups were similar in terms of complications.

Conclusion: Double j stent or percutaneous nephrostomy insertion in patients presenting with postrenal ARF due to ureteral obstruction was found to be similar in terms of efficacy and safety. 

Keywords

• double j stent,percutaneous nephrostomy;,postrenal acute renal failure

Üreteral obstrüksiyona bağlı postrenal akut böbrek yetmezliği olan hastalarda double j stent ve perkütan nefrostominin etkinlik ve güvenlilik açısından karşılaştırılması

Abstract

Amaç: Postrenal akut böbrek yetmezliği (ABY) nedeniyle başvuran hastalarda üreteral double j stent (UDjS) takılması ve perkütan nefrostomi (PCN) takılmasının etkinlik ve güvenliliğini karşılaştırmak

Materyal ve Metod: Kliniğimizde Ocak 2011 ile Nisan 2016 tarihleri arasında üreteral obstrüksiyona bağlı postrenal ABY nedeniyle başvuran ve acil olarak UDjS veya PCN takılan 59 hasta çalışmaya dahil edildi. Hastalar UDjS takılanlar(Grup 1) ve PCN takılanlar(Grup 2) olmak üzere iki gruba ayrıldı. Hastalara işlem sonrası günlük üre ve kreatinin takibi yapıldı. İki grup; kreatinin düşüş hızı, total kretinin değişimi, ve komplikasyonlar açısından karşılaştırıldı.

Bulgular: Grup 1 de UDjS yardımıyla renal pelvis drenajı sağlanmış 40 hasta, grup 2 de ise PCN ile drenajı yapılan 19 hasta vardı. Ortalama takip süresi Grup 1 ve Grup 2 için sırasıyla 6.8±10.3 ve 7.6±4.0 gündü. PCN takılan grupta kreatinin düşüşü anlamlı olarak yüksekti(p<0.001). Ortalama günlük kreatinin düşüşü Grup 1 de 0,31± 0,33, Grup 2 de 0,46± 0,35 mg/dl olarak bulundu(p=0.103). Bazal kre- atinin değerine ulaşma süresi açısından iki grup arasında fark izlenmedi. Grup 2 de hidronefroz derecesi anlamlı olarak daha yüksek bulundu. Clavien-Dindo komplikasyon sınıflamasına göre komplikasyonlar açısından iki grup benzer olarak bulundu.

Sonuç: Üreteral obstrüksiyona bağlı postrenal ABY nedeniyle başvuran hastalarda UDjS veya PCN takılması etkinlik ve güvenlilik açısından benzerdir. 

Keywords

• üreteral stent,perkütan nefrostomi,postrenal ABY

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