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Bilateral pelviureteric junction obstruction causing renal failure in two elderly patients
P G Kerr1, D M Wilson, P S Lawson
1Department of Medicine, Austin Hospital, Heidelberg, Australia.
American Journal of Nephrology
|January 1, 1989
Summary
Pelviureteric junction obstruction, a rare cause of kidney failure in the elderly, is treatable. Prompt diagnosis and intervention, including percutaneous nephrostomy and surgery, can restore kidney function and eliminate the need for dialysis.
Area of Science:
- Nephrology
- Urology
- Radiology
Background:
- Pelviureteric junction (PUJ) obstruction is an uncommon cause of renal failure, particularly in the elderly.
- Prompt diagnosis and management are crucial for potentially reversible kidney failure.
Observation:
- Two elderly patients presented with acute renal failure attributed to PUJ obstruction.
- Initial management included dialysis followed by diagnosis confirmation via radiological imaging.
- Percutaneous nephrostomy was performed to relieve the obstruction.
Findings:
- Differential renal function was assessed using direct measurement and isotope scanning.
- Surgical correction of the PUJ obstruction was performed in both cases.
- At a 2-year follow-up, both patients were free from dialysis, indicating successful renal function recovery.
Implications:
- This case series highlights that PUJ obstruction, though rare in the elderly, is a potentially correctable cause of renal failure.
- Early diagnosis and intervention, including minimally invasive procedures and surgical correction, can lead to long-term recovery of kidney function.
- Consideration of PUJ obstruction in elderly patients presenting with unexplained renal failure is warranted.