Purpose: High urinary retention (HUR) can negatively impact renal function. Our study aimed to present the epidemiological, diagnostic, and therapeutic aspects of HUR in a Senegalese academic hospital. Patients and Methods: We conducted a retrospective study of 70 patients with HUR associated with renal failure from January 2017 to December 2020. Parameters examined included: age, sex, coexisting conditions affecting renal function, clinical symptoms, diagnostic tests, causes of HUR, urinary diversion, and patient outcomes. Results: The average age was 66, with a majority of male patients (87%). Twenty-three patients had pre-existing medical conditions. Oligo-anuria was the most common reason for detecting HUR (70%). Half of the patients had an ECOG score ≥ 2. The mean creatinine level was 50.7 mg/l. Nineteen patients exhibited hydroelectrolytic disorders. Bacterial colonization was observed in 25 patients. Ultrasound and computed tomography were the most frequently performed imaging tests (100% and 62.8%, respectively). Sixty-seven patients had ureterohydronephrosis (UHN), with bilateral UHN in 88.6% of cases. Pelvic cancers (47.1%) were the primary cause of HUR, primarily bladder cancers (27.1%). Nephrostomy was the most common urinary drainage method (50%), particularly for obstructions due to pelvic cancer (88.6%). The majority of patients (52.8%) regained normal renal function after drainage. Nineteen deaths occurred among elderly patients with compromised general health. Conclusion: Urinary drainage significantly improved renal function for most patients. Pelvic cancer emerged as the leading cause of HUR. Nephrostomy was the predominant drainage method.
References
[1]
Yang, J., Sun, B.G., Min, H.J., et al. (2021) Impact of Acute Kidney Injury on Long-Term Adverse Outcomes in Obstructive Uropathy. Scientific Reports, 11, 236-239. https://doi.org/10.1038/s41598-021-03033-0
[2]
Guerrot, D. and Tamion, F. (2013) Obstructive Acute Renal Failure: The Intensivist’s Viewpoint. Progrès en Urologie—FMC, 23, 19-22. https://doi.org/10.1016/j.fpurol.2012.10.001
[3]
Hamdi, A., Hajage, D., Van Glabeke, E., et al. (2012) Severe Post-Renal Acute Kidney Injury, Post-Obstructive Diuresis and Renal Recovery. BJU International, 110, 1027-1034. https://doi.org/10.1111/j.1464-410X.2012.11193.x
[4]
Haymann, J.P., Vinsonneau, C., Girshovich, A., et al. (2017) Acute Obstructive Nephropathy: A Pathophysiological View. Néphrologie & Thérapeutique, 13, S1-S5. https://doi.org/10.1016/j.nephro.2017.01.008
[5]
Oken, M.M., Creech, R.H., Tormey, D.C., et al. (1982) Toxicity and Response Criteria of the Eastern Cooperative Oncology Group. American Journal of Clinical Oncology, 5, 649-655. https://doi.org/10.1097/00000421-198212000-00014
[6]
Sherman, S., Rathnayake, N. and Mdzinarishvil, T. (2015) Invariant Characteristics of Carcinogenesis. PLOS ONE, 10, e0140405. https://doi.org/10.1371/journal.pone.0140405
[7]
Cumberbatch, M.G.K., Jubber, I., Black, P.C., et al. (2018) Epidemiology of Bladder Cancer: A Systematic Review and Contemporary Update of Risk Factors in 2018. European Urology, 74, 784-779. https://doi.org/10.1016/j.eururo.2018.09.001
[8]
Kbirou, A., Sayah, M., Sounni, F., Zamd, M., Benghanem, M.G. et al. (2022) Obstructive Oligo-Anuria Revealing Pelvic Gynecological Cancers, Analysis of a Series of 102 Cases. Annals of Medicine & Surgery, 75, Article 103332. https://doi.org/10.1016/j.amsu.2022.103332
[9]
Mahoney, B.A., Smith, W.A.D., Lo, D., et al. (2005) Emergency Interventions for Hyperkalaemia. Cochrane Database of Systematic Reviews. http://dx.doi.org/10.1002/14651858.CD003235.pub2
[10]
Maillet, P.J., Pelle-Francoz, D., Laville, M., et al. (1986) Non Dilated Obstructive Acute Renal Failure: Diagnostic Procedures and Therapeutic Management. Radiology, 160, 659-662. https://doi.org/10.1148/radiology.160.3.3526405
[11]
Macdonald, D.B., Hurrell, C., Costa, A.F., et al. (2022) Canadian Association of Radiologists Guidance on Contrast Associated Acute Kidney Injury. Canadian Association of Radiologists Journal, 73, 499-514. https://doi.org/10.1177/08465371221083970
[12]
Guerrot, D., Kerroch, M., Placier, S., et al. (2011) Discoidin Domain Receptor 1 Is a Major Mediator of Inflammation and Fibrosis in Obstructive Nephropathy. The American Journal of Pathology, 179, 83-91. https://doi.org/10.1016/j.ajpath.2011.03.023
[13]
Forbes, M.S., Thornhill, B.A. and Chevalier, R.L. (2011) Proximal Tubular Injury and Rapid Formation of a Tubular Glomeruli in Mice with Unilateral Ureteral Obstruction: A New Look at an Old Model. American Journal of Physiology-Renal Physiology, 301, 110-117. https://doi.org/10.1152/ajprenal.00022.2011
[14]
Lienert, A., Ing, A. and Mark, S. (2009) Prognostic Factors in Malignant Ureteric Obstruction. BJU International, 104, 938-941. https://doi.org/10.1111/j.1464-410X.2009.08492.x
[15]
Garg, G., Bansal, N., Singh, M., et al. (2019) Role of Percutaneous Nephrostomy in Bladder Carcinoma with Obstructive Uropathy: A Story Revisited. Indian Journal of Palliative Care, 25, 53-56.
[16]
Azwadi, I.Z.K., Norhayati, M.N. and Abdullah, M.S. (2021) Percutaneous Nephrostomy versus Retrograde Ureteral Stenting for Acute Upper Obstructive Uropathy: A Systematic Review and Meta-Analysis. Scientific Reports, 11, Article No. 6613. https://doi.org/10.1038/s41598-021-86136-y
[17]
Chevalier, R.L., Forbes, B.A.M.S. and Thornhill, B.A. (2009) Ureteral Obstruction as a Model of Renal Interstitial Fibrosis and Obstructive Nephropathy. Kidney International, 75, 1145-1152. https://doi.org/10.1038/ki.2009.86
[18]
Cordeiro, M.D., Coelho, R.F., Chade, D.C., Pessoa, R.R., Chaib, M.S., José, R. and Colombo-Júnior, J.R. (2016) A Prognostic Model for Survival after Palliative Urinary Diversion for Malignant Ureteric Obstruction: A Prospective Study of 208 Patients. BJU International, 117, 266-271. https://doi.org/10.1111/bju.12963
[19]
Saha, M. and Allon, M. (2017) Diagnosis, Treatment, and Prevention of Hemodialysis Emergencies. Clinical Journal of the American Society of Nephrology, 12, 357-369. https://doi.org/10.2215/CJN.05260516
