Effect of Nephrostomy on Relative Function of Obstructed Kidney

Not Applicable

Completed

• Conditions: Obstructive Uropathy
• Interventions: Procedure: Percutaneous nephrostomy

• Registration Number: NCT03936673
• Lead Sponsor: TC Erciyes University

Brief Summary

Urinary tract obstruction is a serious health problem due to kidney damage. Relative renal function has an important role in the treatment of obstructed kidneys. Nephrectomy can be recommended when the relative renal function is 10% or less in radionuclide examinations. Recently, however, nephron sparing approaches have come to the fore. This indicated the need to evaluate the possibility of recovering the function of the kidney before nephrectomy. The aim of this study is to compare relative functions of obstructed kidneys in technetium 99m dimercaptosuccinic acid scintigraphy (DMSA) before and 2 weeks after nephrostomy tube.

Detailed Description

Obstructive uropathy is one of the most important causes of acute renal injury and end-stage renal failure. obstruction of urine flow increases the intratubular pressure. This pressure increase causes decrease in renal blood flow and starts the inflammatory process. In the first few hours after total ureter obstruction, due to the increase in intratubular pressure glomerular filtration ceases and tubular transport is markedly decreased. Long lasting obstruction results in renal fibrosis and end stage renal damage. Basically obstructive uropathy leading to irreversible renal damage and loss of renal function is the main indication for simple nephrectomy. Serious renal parenchymal damage is defined as non-functioning kidney having relative renal function (RRF) 10% or less in the literature. But recently in some studies it was suggested that by applying the nephrostomy catheter, ability of kidney to regain function can be evaluated before nephrectomy. So, possibility of gaining function should be kept in mind. In this study effect of percutaneous nephrostomy tube on serum creatinine, blood urea nitrogen (BUN) and RRF in obstructed kidney with RRF 10% or less. Before and 2 weeks after percutaneous nephrostomy, serum creatinine, ure and RRF in DMSA was recorded and compared.

Study Timeline

• Study Start: 2014-07-01
• Primary Completion: 2018-05-31
• Study Completion: 2019-01-01
• Status Verified: 2019-05
• Study First Submitted: 2019-05-01
• Study First Submitted QC: 2019-05-01
• Last Update Submitted: 2019-05-01
• Study First Posted: 2019-05-03
• Last Update Posted: 2019-05-03

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 18

Inclusion Criteria

• Unilateral obstructed kidney with RRF 10% or less
• Unilateral obstructed kidney with grade 2 or more hydroureteronephrosis
• Defined etiology for unilateral obstructed kidney
• estimated glomerular filtration rate (GFR) ≥ 30ml/min
• Approving the nephrostomy procedure

Exclusion Criteria

• Unilateral obstructed kidney with RRF above 10%
• Estimated GFR <30 ml/min
• diagnosis of bilateral obstructed kidneys
• not approving nephrostomy

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: SINGLE_GROUP

Arm && Interventions

Group	Intervention	Description
atrophic kidney	Percutaneous nephrostomy	Patients diagnosed with unilateral obstructed kidney with RRF 10% or less underwent application of percutaneous nephrostomy tube on affected side.

Primary Outcome Measures

Name	Time	Method
Serum BUN level 2 weeks after nephrostomy	2 weeks after nephrostomy	Serum BUN level 2 weeks after nephrostomy
RRF in DMSA 2 weeks after nephrostomy	2 weeks after nephrostomy	RRF in DMSA 2 weeks after nephrostomy
serum creatinine level 2 weeks after nephrostomy	2 weeks after nephrostomy	serum creatinine level 2 weeks after nephrostomy

Trial Locations

Locations (1)

Department of Urology, Ercieys University, Faculty Of Medicine,; 🇹🇷 Kayseri, Turkey