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. 2018 Nov;59(6):376-382.
doi: 10.4111/icu.2018.59.6.376. Epub 2018 Oct 26.

Renal function is associated with prognosis in stent-change therapy for malignant ureteral obstruction

Ji Hyung Yoon  1 , Sejun Park  1 , Sungchan Park  1 , Kyung Hyun Moon  1 , Sang Hyeon Cheon  1 , Taekmin Kwon  1
Affiliations

Renal function is associated with prognosis in stent-change therapy for malignant ureteral obstruction

Ji Hyung Yoon et al. Investig Clin Urol. 2018 Nov.

Abstract

Purpose: The authors performed this study to investigate the risk factors for predicting stent failure and to evaluate its impact on prognosis.

Materials and methods: Between January 2002 and March 2017, we retrospectively reviewed 117 consecutive patients who underwent retrograde ureteral stenting and exchanging at least once every 3 months for malignant ureteral obstruction. The patients were classified according to their pre-stenting chronic kidney disease (CKD) stage. The factors affecting stent failure were analyzed using a logistic regression model. Overall survival (OS) was estimated, and the prognostic significance of each variable was estimated using Cox proportional-hazards regression modeling.

Results: Before stenting, 91 patients were CKD stages 1-3 and 26 patients were CKD stages 4-5. These two groups differed significantly only in pre-stenting estimated glomerular filtration rate (eGFR), bilateral obstruction, and pre-stenting pyuria. Among the 117 patients, stent failure occurred in 30 patients (25.6%), and there were no differences between the groups. Pre-stenting pyuria and post-stenting complications were significant predictors of stent failure. There were 79 deaths in total, including 56 in the CKD stages 1-3 group and 23 in the CKD stages 4-5 group. In the multivariate analysis predicting patient OS, pre-stenting eGFR and post-stenting disease progression were significant factors.

Conclusions: Internal ureteral stenting was effective for maintaining renal function in malignant ureteral obstruction. However, it did not restore renal function, which is related to the prognosis of the patients. Therefore, to improve patients' renal function and prognosis, patients who require stenting must be quickly recognized and treated.

Keywords: Kidney; Prognosis; Stent; Ureteral obstruction.

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Conflict of interest statement

CONFLICTS OF INTEREST: The authors have nothing to disclose.

Figures

Fig. 1
Fig. 1. Estimated glomerular filtration rate (eGFR) changes after stenting. (A) In all patients. (B) According to pre-stenting renal function. CKD, chronic kidney disease.
Fig. 2
Fig. 2. Kaplan–Meier analysis of overall survival after stenting. (A) All cohorts. (B) According to pre-stenting renal function. CKD, chronic kidney disease.
See this image and copyright information in PMC

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