Skip to main content
Erschienen in: Urolithiasis 3/2017

07.07.2016 | Original Paper

Transient renal impairment in the absence of pre-existing chronic kidney disease in patients with unilateral ureteric stone impaction

verfasst von: Hee Youn Kim, Hyun-Sop Choe, Dong Sup Lee, Jae Mo Yoo, Seung-Ju Lee

Erschienen in: Urolithiasis | Ausgabe 3/2017

Einloggen, um Zugang zu erhalten

Abstract

This study aims to describe the rate and characteristics of transient renal impairment in unilateral ureteric stone patients without chronic kidney disease (CKD) and to identify factors that may have influenced renal function of these patients. Unilateral ureteric stone patients who visited our hospital’s emergency department from December, 2009 to December, 2015 were divided into two groups based on estimated glomerular filtration rate (eGFR): group I (patients with eGFR ≥ 60 ml/min/1.73 m2) and group II (eGFR < 60 ml/min/1.73 m2). A univariate comparison between groups I and II was performed. Multivariable logistic regression analysis was performed to determine factors that influenced renal function. There were 107 patients in group II, which constituted 5.6 % of the total patients. In the multivariable logistic regression analysis, age (p < 0.001, odds ratio [OR] = 1.069, confidence interval [CI] = 1.049–1.089), hypertension (p < 0.001, OR = 2.302, CI = 1.467–3.611), stone size (p = 0.001, OR = 1.141, CI = 1.057–1.231), white blood cell count (p = 0.001, OR = 1.132, CI = 1.055–1.215) and hematuria (p < 0.001, OR = 0.383, CI = 0.231–0.636) were found to be independent factors for renal impairment. Based on the results of this study, the rate of renal impairment was 6 % of the unilateral ureteric stone patients without pre-existing CKD. Age and hypertension were found to be independent factors for renal impairment; NSAIDs should be used cautiously or other agents for pain relief such as opioids should be considered in old aged patients with hypertension.
Literatur
3.
Zurück zum Zitat Stillman MT, Schlesinger PA (1990) Nonsteroidal anti-inflammatory drug nephrotoxicity. Should we be concerned? Arch Intern Med 150(2):268–270CrossRefPubMed Stillman MT, Schlesinger PA (1990) Nonsteroidal anti-inflammatory drug nephrotoxicity. Should we be concerned? Arch Intern Med 150(2):268–270CrossRefPubMed
4.
Zurück zum Zitat Whelton A (1999) Nephrotoxicity of nonsteroidal anti-inflammatory drugs: physiologic foundations and clinical implications. Am J Med 106(5B):13S–24SCrossRefPubMed Whelton A (1999) Nephrotoxicity of nonsteroidal anti-inflammatory drugs: physiologic foundations and clinical implications. Am J Med 106(5B):13S–24SCrossRefPubMed
5.
Zurück zum Zitat Brater DC (1999) Effects of nonsteroidal anti-inflammatory drugs on renal function: focus on cyclooxygenase-2-selective inhibition. Am J Med 107(6A):65S–70S (discussion 70S–71S) CrossRefPubMed Brater DC (1999) Effects of nonsteroidal anti-inflammatory drugs on renal function: focus on cyclooxygenase-2-selective inhibition. Am J Med 107(6A):65S–70S (discussion 70S–71S) CrossRefPubMed
7.
Zurück zum Zitat Beetz R, Bokenkamp A, Brandis M, Hoyer P, John U, Kemper MJ, Kirschstein M, Kuwertz-Broking E, Misselwitz J, Muller-Wiefel DE, Rascher W (2001) Diagnosis of congenital dilatation of the urinary tract. Consensus Group of the Pediatric Nephrology Working Society in cooperation with the Pediatric Urology Working Group of the German Society of Urology and with the Pediatric Urology Working Society in the Germany Society of Pediatric Surgery. Urologe A 40(6):495–507 (quiz 508–499) CrossRefPubMed Beetz R, Bokenkamp A, Brandis M, Hoyer P, John U, Kemper MJ, Kirschstein M, Kuwertz-Broking E, Misselwitz J, Muller-Wiefel DE, Rascher W (2001) Diagnosis of congenital dilatation of the urinary tract. Consensus Group of the Pediatric Nephrology Working Society in cooperation with the Pediatric Urology Working Group of the German Society of Urology and with the Pediatric Urology Working Society in the Germany Society of Pediatric Surgery. Urologe A 40(6):495–507 (quiz 508–499) CrossRefPubMed
8.
Zurück zum Zitat Levey AS, Coresh J, Greene T, Stevens LA, Zhang YL, Hendriksen S, Kusek JW, Van Lente F, Chronic Kidney Disease Epidemiology C (2006) Using standardized serum creatinine values in the modification of diet in renal disease study equation for estimating glomerular filtration rate. Ann Intern Med 145(4):247–254CrossRefPubMed Levey AS, Coresh J, Greene T, Stevens LA, Zhang YL, Hendriksen S, Kusek JW, Van Lente F, Chronic Kidney Disease Epidemiology C (2006) Using standardized serum creatinine values in the modification of diet in renal disease study equation for estimating glomerular filtration rate. Ann Intern Med 145(4):247–254CrossRefPubMed
9.
Zurück zum Zitat Castle WN, McDougal WS (1984) Contralateral renal hyperplasia and increased renal function after relief of chronic unilateral ureteral obstruction. J Urol 132(5):1016–1020PubMed Castle WN, McDougal WS (1984) Contralateral renal hyperplasia and increased renal function after relief of chronic unilateral ureteral obstruction. J Urol 132(5):1016–1020PubMed
10.
Zurück zum Zitat Pearle MS, Pierce HL, Miller GL, Summa JA, Mutz JM, Petty BA, Roehrborn CG, Kryger JV, Nakada SY (1998) Optimal method of urgent decompression of the collecting system for obstruction and infection due to ureteral calculi. J Urol 160(4):1260–1264CrossRefPubMed Pearle MS, Pierce HL, Miller GL, Summa JA, Mutz JM, Petty BA, Roehrborn CG, Kryger JV, Nakada SY (1998) Optimal method of urgent decompression of the collecting system for obstruction and infection due to ureteral calculi. J Urol 160(4):1260–1264CrossRefPubMed
11.
Zurück zum Zitat Shen W, Li W, Pan J, Yan J, Xiong E, Li L, Zhou Z, Song B, Lu G (2011) Specific management of acute renal failure caused by an upper ureteral stone in a solitary pelvic kidney. Urol Res 39(1):77–79. doi:10.1007/s00240-010-0268-3 CrossRefPubMed Shen W, Li W, Pan J, Yan J, Xiong E, Li L, Zhou Z, Song B, Lu G (2011) Specific management of acute renal failure caused by an upper ureteral stone in a solitary pelvic kidney. Urol Res 39(1):77–79. doi:10.​1007/​s00240-010-0268-3 CrossRefPubMed
12.
Zurück zum Zitat Tan FQ, Shen BH, Xie LP, Meng HZ, Fang DB, Wang CJ (2013) Management experience of acute renal failure induced by unilateral ureteral calculi obstruction. Zhonghua Yi Xue Za Zhi 93(20):1580–1582PubMed Tan FQ, Shen BH, Xie LP, Meng HZ, Fang DB, Wang CJ (2013) Management experience of acute renal failure induced by unilateral ureteral calculi obstruction. Zhonghua Yi Xue Za Zhi 93(20):1580–1582PubMed
13.
Zurück zum Zitat Al-Ani A, Al-Jalham K, Ibrahim T, Majzoub A, Al-Rayashi M, Hayati A, Mubarak W, Al-Rayahi J, Khairy AT (2015) Factors determining renal impairment in unilateral ureteral colic secondary to calcular disease: a prospective study. Int Urol Nephrol 47(7):1085–1090. doi:10.1007/s11255-015-0986-0 CrossRefPubMed Al-Ani A, Al-Jalham K, Ibrahim T, Majzoub A, Al-Rayashi M, Hayati A, Mubarak W, Al-Rayahi J, Khairy AT (2015) Factors determining renal impairment in unilateral ureteral colic secondary to calcular disease: a prospective study. Int Urol Nephrol 47(7):1085–1090. doi:10.​1007/​s11255-015-0986-0 CrossRefPubMed
14.
Zurück zum Zitat Levey AS, de Jong PE, Coresh J, El Nahas M, Astor BC, Matsushita K, Gansevoort RT, Kasiske BL, Eckardt KU (2011) The definition, classification, and prognosis of chronic kidney disease: a KDIGO controversies conference report. Kidney Int 80(1):17–28. doi:10.1038/ki.2010.483 CrossRefPubMed Levey AS, de Jong PE, Coresh J, El Nahas M, Astor BC, Matsushita K, Gansevoort RT, Kasiske BL, Eckardt KU (2011) The definition, classification, and prognosis of chronic kidney disease: a KDIGO controversies conference report. Kidney Int 80(1):17–28. doi:10.​1038/​ki.​2010.​483 CrossRefPubMed
16.
Zurück zum Zitat Rowe JW, Andres R, Tobin JD, Norris AH, Shock NW (1976) The effect of age on creatinine clearance in men: a cross-sectional and longitudinal study. J Gerontol 31(2):155–163CrossRefPubMed Rowe JW, Andres R, Tobin JD, Norris AH, Shock NW (1976) The effect of age on creatinine clearance in men: a cross-sectional and longitudinal study. J Gerontol 31(2):155–163CrossRefPubMed
17.
Zurück zum Zitat Hollenberg NK, Adams DF, Solomon HS, Rashid A, Abrams HL, Merrill JP (1974) Senescence and the renal vasculature in normal man. Circ Res 34(3):309–316CrossRefPubMed Hollenberg NK, Adams DF, Solomon HS, Rashid A, Abrams HL, Merrill JP (1974) Senescence and the renal vasculature in normal man. Circ Res 34(3):309–316CrossRefPubMed
18.
Zurück zum Zitat Bolton WK, Benton FR, Maclay JG, Sturgill BC (1976) Spontaneous glomerular sclerosis in aging Sprague-Dawley rats. I. Lesions associated with mesangial IgM deposits. Am J Pathol 85(2):277–302PubMedPubMedCentral Bolton WK, Benton FR, Maclay JG, Sturgill BC (1976) Spontaneous glomerular sclerosis in aging Sprague-Dawley rats. I. Lesions associated with mesangial IgM deposits. Am J Pathol 85(2):277–302PubMedPubMedCentral
19.
Zurück zum Zitat Castellani S, Ungar A, Cantini C, La Cava G, Di Serio C, Altobelli A, Vallotti B, Pellegri M, Brocchi A, Camaiti A, Coppo M, Meldolesi U, Messeri G, Masotti G (1998) Excessive vasoconstriction after stress by the aging kidney: inadequate prostaglandin modulation of increased endothelin activity. J Lab Clin Med 132(3):186–194CrossRefPubMed Castellani S, Ungar A, Cantini C, La Cava G, Di Serio C, Altobelli A, Vallotti B, Pellegri M, Brocchi A, Camaiti A, Coppo M, Meldolesi U, Messeri G, Masotti G (1998) Excessive vasoconstriction after stress by the aging kidney: inadequate prostaglandin modulation of increased endothelin activity. J Lab Clin Med 132(3):186–194CrossRefPubMed
20.
Zurück zum Zitat Tank JE, Vora JP, Houghton DC, Anderson S (1994) Altered renal vascular responses in the aging rat kidney. Am J Physiol 266(6 Pt 2):F942–F948PubMed Tank JE, Vora JP, Houghton DC, Anderson S (1994) Altered renal vascular responses in the aging rat kidney. Am J Physiol 266(6 Pt 2):F942–F948PubMed
22.
Zurück zum Zitat Kaplan C, Pasternack B, Shah H, Gallo G (1975) Age-related incidence of sclerotic glomeruli in human kidneys. Am J Pathol 80(2):227–234PubMedPubMedCentral Kaplan C, Pasternack B, Shah H, Gallo G (1975) Age-related incidence of sclerotic glomeruli in human kidneys. Am J Pathol 80(2):227–234PubMedPubMedCentral
26.
Zurück zum Zitat Keane WF, Eknoyan G (1999) Proteinuria, albuminuria, risk, assessment, detection, elimination (PARADE): a position paper of the National Kidney Foundation. Am J Kidney Dis 33(5):1004–1010CrossRefPubMed Keane WF, Eknoyan G (1999) Proteinuria, albuminuria, risk, assessment, detection, elimination (PARADE): a position paper of the National Kidney Foundation. Am J Kidney Dis 33(5):1004–1010CrossRefPubMed
27.
Zurück zum Zitat Yoshioka T, Rennke HG, Salant DJ, Deen WM, Ichikawa I (1987) Role of abnormally high transmural pressure in the permselectivity defect of glomerular capillary wall: a study in early passive Heymann nephritis. Circ Res 61(4):531–538CrossRefPubMed Yoshioka T, Rennke HG, Salant DJ, Deen WM, Ichikawa I (1987) Role of abnormally high transmural pressure in the permselectivity defect of glomerular capillary wall: a study in early passive Heymann nephritis. Circ Res 61(4):531–538CrossRefPubMed
28.
Zurück zum Zitat Finlay S, Bray B, Lewington AJ, Hunter-Rowe CT, Banerjee A, Atkinson JM, Jones MC (2013) Identification of risk factors associated with acute kidney injury in patients admitted to acute medical units. Clin Med (Lond) 13(3):233–238. doi:10.7861/clinmedicine.13-3-233 CrossRef Finlay S, Bray B, Lewington AJ, Hunter-Rowe CT, Banerjee A, Atkinson JM, Jones MC (2013) Identification of risk factors associated with acute kidney injury in patients admitted to acute medical units. Clin Med (Lond) 13(3):233–238. doi:10.​7861/​clinmedicine.​13-3-233 CrossRef
29.
Zurück zum Zitat Leblanc M, Kellum JA, Gibney RT, Lieberthal W, Tumlin J, Mehta R (2005) Risk factors for acute renal failure: inherent and modifiable risks. Curr Opin Crit Care 11(6):533–536CrossRefPubMed Leblanc M, Kellum JA, Gibney RT, Lieberthal W, Tumlin J, Mehta R (2005) Risk factors for acute renal failure: inherent and modifiable risks. Curr Opin Crit Care 11(6):533–536CrossRefPubMed
31.
Zurück zum Zitat Rosenzweig B, Pinthus JH, Kleinmann N, Joffe E, Erlich T, Fridman E, Winkler H, Mor Y, Ramon J, Dotan ZA (2015) The relative contribution of urine extravasation to elevate plasma creatinine levels in acute unilateral ureteral obstruction. Can Urol Assoc J 9(7–8):E428–E433. doi:10.5489/cuaj.2804 CrossRefPubMedPubMedCentral Rosenzweig B, Pinthus JH, Kleinmann N, Joffe E, Erlich T, Fridman E, Winkler H, Mor Y, Ramon J, Dotan ZA (2015) The relative contribution of urine extravasation to elevate plasma creatinine levels in acute unilateral ureteral obstruction. Can Urol Assoc J 9(7–8):E428–E433. doi:10.​5489/​cuaj.​2804 CrossRefPubMedPubMedCentral
Metadaten
Titel
Transient renal impairment in the absence of pre-existing chronic kidney disease in patients with unilateral ureteric stone impaction
verfasst von
Hee Youn Kim
Hyun-Sop Choe
Dong Sup Lee
Jae Mo Yoo
Seung-Ju Lee
Publikationsdatum
07.07.2016
Verlag
Springer Berlin Heidelberg
Erschienen in
Urolithiasis / Ausgabe 3/2017
Print ISSN: 2194-7228
Elektronische ISSN: 2194-7236
DOI
https://doi.org/10.1007/s00240-016-0904-7

Weitere Artikel der Ausgabe 3/2017

Urolithiasis 3/2017 Zur Ausgabe

Update Urologie

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