Skip to main content
Erschienen in: International Urology and Nephrology 1/2015

01.01.2015 | Urology - Original Paper

Outcomes of stent-change therapy for bilateral malignancy-related ureteral obstruction

verfasst von: Sang Hoon Song, Sahyun Pak, In Gab Jeong, Kun Suk Kim, Hyung Keun Park, Choung-Soo Kim, Hanjong Ahn, Bumsik Hong

Erschienen in: International Urology and Nephrology | Ausgabe 1/2015

Einloggen, um Zugang zu erhalten

Abstract

Objective

To study the long-term outcomes of stent-change therapy for malignancy-related ureteral obstruction in terms of renal function outcomes.

Methods

We retrospectively reviewed 87 consecutive patients who underwent bilateral ureteral stenting for malignant bilateral ureteral obstruction. Predictive value of clinical variables, such as age, sex, comorbidities, renal function at time of stenting, and securing of the dominant functional kidney or both with early percutaneous nephrostomy (PCN) conversion on renal function preservation, were analyzed.

Results

The mean serum Cr level was 3.3 mg/dl at the time of bilateral stenting, which significantly decreased to 1.6 mg/dl at 6 months post-stenting and progressively deteriorated to 2.3 mg/dl at 3 years post-stenting. Chronic kidney disease (CKD) stage 4 or 5 developed in 18.3 % of patients at 6 months post-stenting and in 57.2 % at 3 years post-stenting. During the follow-up period, 12 patients (13.8 %) had PCN conversion. Patients who had early PCN conversion before progression to CKD 4 or more tended to show a better renal function outcome than patients with CKD 4 or more who had late PCN conversion or no conversion. Multivariate analysis showed that an age older than 55 years, diabetes, and an eGFR <60 before obstructive symptoms or signs were significant predictive factors for the development of CKD stage 4 or more.

Conclusions

To preserve renal function, patients with bilateral malignant ureteral obstruction, especially those aged 55 or more or with diabetes or poor baseline renal function, should be considered for early PCN conversion in the dominant functional kidney or both.
Literatur
1.
Zurück zum Zitat Shekarriz B, Shekarriz H, Upadhyay J, Banerjee M, Becker H, Pontes JE, Wood DP Jr (1999) Outcome of palliative urinary diversion in the treatment of advanced malignancies. Cancer 85(4):998–1003PubMedCrossRef Shekarriz B, Shekarriz H, Upadhyay J, Banerjee M, Becker H, Pontes JE, Wood DP Jr (1999) Outcome of palliative urinary diversion in the treatment of advanced malignancies. Cancer 85(4):998–1003PubMedCrossRef
6.
Zurück zum Zitat Levey AS, Bosch JP, Lewis JB, Greene T, Rogers N, Roth D (1999) A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Modification of Diet in Renal Disease Study Group. Ann Intern Med 130(6):461–470PubMedCrossRef Levey AS, Bosch JP, Lewis JB, Greene T, Rogers N, Roth D (1999) A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Modification of Diet in Renal Disease Study Group. Ann Intern Med 130(6):461–470PubMedCrossRef
7.
Zurück zum Zitat Radecka E, Magnusson M, Magnusson A (2006) Survival time and period of catheterization in patients treated with percutaneous nephrostomy for urinary obstruction due to malignancy. Acta Radiol 47(3):328–331PubMedCrossRef Radecka E, Magnusson M, Magnusson A (2006) Survival time and period of catheterization in patients treated with percutaneous nephrostomy for urinary obstruction due to malignancy. Acta Radiol 47(3):328–331PubMedCrossRef
8.
Zurück zum Zitat Chapman ME, Reid JH (1991) Use of percutaneous nephrostomy in malignant ureteric obstruction. Br J Radiol 64(760):318–320PubMedCrossRef Chapman ME, Reid JH (1991) Use of percutaneous nephrostomy in malignant ureteric obstruction. Br J Radiol 64(760):318–320PubMedCrossRef
10.
Zurück zum Zitat Harrington KJ, Pandha HS, Kelly SA, Lambert HE, Jackson JE, Waxman J (1995) Palliation of obstructive nephropathy due to malignancy. Br J Urol 76(1):101–107PubMedCrossRef Harrington KJ, Pandha HS, Kelly SA, Lambert HE, Jackson JE, Waxman J (1995) Palliation of obstructive nephropathy due to malignancy. Br J Urol 76(1):101–107PubMedCrossRef
11.
Zurück zum Zitat Zadra JA, Jewett MA, Keresteci AG, Rankin JT, St Louis E, Grey RR, Pereira JJ (1987) Nonoperative urinary diversion for malignant ureteral obstruction. Cancer 60(6):1353–1357PubMedCrossRef Zadra JA, Jewett MA, Keresteci AG, Rankin JT, St Louis E, Grey RR, Pereira JJ (1987) Nonoperative urinary diversion for malignant ureteral obstruction. Cancer 60(6):1353–1357PubMedCrossRef
Metadaten
Titel
Outcomes of stent-change therapy for bilateral malignancy-related ureteral obstruction
verfasst von
Sang Hoon Song
Sahyun Pak
In Gab Jeong
Kun Suk Kim
Hyung Keun Park
Choung-Soo Kim
Hanjong Ahn
Bumsik Hong
Publikationsdatum
01.01.2015
Verlag
Springer Netherlands
Erschienen in
International Urology and Nephrology / Ausgabe 1/2015
Print ISSN: 0301-1623
Elektronische ISSN: 1573-2584
DOI
https://doi.org/10.1007/s11255-014-0858-z

Weitere Artikel der Ausgabe 1/2015

International Urology and Nephrology 1/2015 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.