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

Year 2018, Volume: 13 Issue: 3, 6 - 9, 01.10.2018

Ertuğrul Şefik , İsmail Basmacı Özgü Aydoğdu Salih Polat İbrahim Halil Bozkurt Tansu Değirmenci Çetin Dinçel

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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