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Published in: Urolithiasis 3/2017

01-06-2017 | Original Paper

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

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

Published in: Urolithiasis | Issue 3/2017

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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.
Literature
3.
go back to reference 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.
go back to reference 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.
go back to reference 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.
go back to reference 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.
go back to reference 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.
go back to reference 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.
go back to reference 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.
12.
go back to reference 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.
go back to reference 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.
go back to reference 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.
go back to reference 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.
go back to reference 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.
go back to reference 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.
go back to reference 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.
go back to reference 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.
go back to reference 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.
go back to reference 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.
go back to reference 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.
go back to reference 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.
go back to reference 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.
go back to reference 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
Metadata
Title
Transient renal impairment in the absence of pre-existing chronic kidney disease in patients with unilateral ureteric stone impaction
Authors
Hee Youn Kim
Hyun-Sop Choe
Dong Sup Lee
Jae Mo Yoo
Seung-Ju Lee
Publication date
01-06-2017
Publisher
Springer Berlin Heidelberg
Published in
Urolithiasis / Issue 3/2017
Print ISSN: 2194-7228
Electronic ISSN: 2194-7236
DOI
https://doi.org/10.1007/s00240-016-0904-7

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