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Multicenter Study
. 2021 Dec 8;11(1):23639.
doi: 10.1038/s41598-021-03033-0.

Impact of acute kidney injury on long-term adverse outcomes in obstructive uropathy

Jihyun Yang #  1 , Bong Gyun Sun #  1 , Hyeon-Jin Min  1 , Young-Bin Son  1 , Tae Bum Kim  1 , Jonghyun Lee  1 , Se Won Oh  1 , Myung-Gyu Kim  1 , Won Yong Cho  1 , Shin Young Ahn  2 , Gang-Jee Ko  2 , Young Joo Kwon  2 , Jin Joo Cha  3 , Young Sun Kang  3 , Dae Ryong Cha  3 , Sang-Kyung Jo  4
Affiliations
Multicenter Study

Impact of acute kidney injury on long-term adverse outcomes in obstructive uropathy

Jihyun Yang et al. Sci Rep. .

Abstract

Obstructive uropathy is known to be associated with acute kidney injury (AKI). This study aimed to investigate the etiologies, clinical characteristics, consequences and also assess the impact of AKI on long-term outcomes. This multicenter, retrospective study of 1683 patients with obstructive uropathy who underwent percutaneous nephrostomy (PCN) analyzed clinical characteristics, outcomes including progression to end-stage kidney disease (ESKD), overall mortality, and the impact of AKI on long-term outcomes. Obstructive uropathy in adults was most commonly caused by malignancy, urolithiasis, and other causes. AKI was present in 78% of the patients and was independently associated with preexisting chronic kidney disease (CKD). Short-term recovery was achieved in 56.78% after the relief of obstruction. ESKD progression rate was 4.4% in urolithiasis and 6.8% in other causes and older age, preexisting CKD, and stage 3 AKI were independent factors of progression. The mortality rate (34%) was highly attributed to malignant obstruction (52%) stage 3 AKI was also an independent predictor of mortality in non-malignant obstruction. AKI is a frequent complication of adult obstructive uropathy. AKI negatively affects long-term kidney outcomes and survival in non-malignant obstructions. A better understanding of the epidemiology and prognostic factors is needed for adult obstructive uropathy.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Enrollment and outcomes. Among 2127 patients who underwent PCN for obstructive uropathy between January 1, 2002 and December 31, 2018, in three tertiary hospitals were assessed for the inclusions, patients were excluded and finally 1683 patients were enrolled for assessment. According to PCN divided into three etiologies, the short-term renal outcome, long term renal outcome and all-cause mortality were schematized.
Figure 2
Figure 2
Cumulative survival of patients with obstructive uropathy according to AKI. The cumulative survival rates varied significantly with the AKI phase in non-malignancy related PCN. However, it was not different in malignancy related PCN.
See this image and copyright information in PMC

References

    1. Wang SJ, Mu XN, Zhang LY, Liu QY, Jin XB. The incidence and clinical features of acute kidney injury secondary to ureteral calculi. Urol. Res. 2012;40:345–348. doi: 10.1007/s00240-011-0414-6. - DOI - PubMed
    1. Benfield MR, McDonald RA, Bartosh S, Ho PL, Harmon W. Changing trends in pediatric transplantation: 2001 Annual Report of the North American Pediatric Renal Transplant Cooperative Study. Pediatr. Transplant. 2003;7:321–335. doi: 10.1034/j.1399-3046.2003.00029.x. - DOI - PubMed
    1. Selkurt EE, Deetjen P, Brechtelsbauer H. Tubular pressure gradients and filtration dynamics during urinary stop flow in the rat. Pflugers Arch. Gesamte Physiol. Menschen Tiere. 1965;286:19–35. doi: 10.1007/BF00362678. - DOI - PubMed
    1. Klahr S, Pukerson ML. The pathophysiology of obstructive nephropathy: The role of vasoactive compounds in the hemodynamic and structural abnormalities of the obstructed kidney. Am. J. Kidney Dis. 1994;23:219–223. doi: 10.1016/S0272-6386(12)80975-9. - DOI - PubMed
    1. Klahr S, Morrissey J. Obstructive nephropathy and renal fibrosis. Am. J. Physiol. Renal Physiol. 2002;283:F861–875. doi: 10.1152/ajprenal.00362.2001. - DOI - PubMed

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