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Stabilization of renal deterioration caused by bladder volume dependent obstruction
Jemma M Hale1, Daniel N Wood, Ivan M Y Hoh
1St. Peter's Centre for Urology, University College London Hospitals, University College, London, United Kingdom.
The Journal of Urology
|August 22, 2009
Summary
Maintaining bladder volume below a critical level can stabilize renal function in patients with bladder volume-dependent renal obstruction. This study found no significant change in creatinine levels, indicating a halt in renal deterioration.
Area of Science:
- Nephrology
- Urology
- Medical Imaging
Background:
- Excessive bladder filling at normal pressure negatively impacts renal function in dilated renal units.
- A critical bladder filling volume has been identified that impedes upper tract drainage.
Purpose of the Study:
- To determine if maintaining bladder volume below a critical level can prevent further renal deterioration.
- To assess the long-term effects of controlled bladder filling on renal function.
Main Methods:
- Follow-up data from 20 patients with progressive renal function deterioration were analyzed.
- Creatinine levels were used to monitor renal function over a mean follow-up of 27 months.
- Paired Student t-test was used for data analysis.
Main Results:
- Data from 14 patients (mean age 34.4 years) were analyzed, with a mean baseline glomerular filtration rate of 42 ml/min/1.73 m(2).
- No significant difference was observed in mean creatinine levels between baseline and latest follow-up (168 vs 185 micromol/l, p >0.05).
- Patient cohort included various conditions like neuropathic bladder, posterior urethral valves, and bladder exstrophy.
Conclusions:
- Consistently maintaining bladder volume below the critical level can stabilize renal function in patients with bladder volume-dependent renal obstruction.
- This strategy appears effective in halting renal deterioration in the studied patient group.
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