Analysis of efficacy factors in unilateral obstructive severe renal insufficiency: a single-centre retrospective...

To investigate the predictors of renal function recovery after treatment of severe renal impairment in unilateral upper urinary tract obstruction (UUTO).

A retrospective analysis was conducted on 153 patients with unilateral UUTO-induced severe renal injury admitted to the First Affiliated Hospital of Chongqing Medical University from January 2014 to January 2023. Independent variables included pre-treatment estimated glomerular filtration rate (eGFR), pre-treatment ^99mTc-diethylenetriaminepentaacetic acid (^99mTc-DTPA) dynamic renal scintigraphy GFR values, C-reactive protein (CRP) levels, and body mass index. These variables were subjected to multiple linear regression analysis to predict changes in GFR (GFRd) post-treatment, with statistical significance set at P < 0.05. Categorical variables, including sex, site of obstruction, eGFR value and nephrectomy were compared with GFRd using two-sample t-tests or one-way ANOVA, with significance at P < 0.05.

Multiple linear regression identified a significant correlation between pre-treatment ^99mTc-DTPA dynamic renal scintigraphy GFR values and CRP levels with GFRd. Female patients and those with renal pelvic obstruction exhibited a higher mean GFRd compared to males and those with ureteral obstruction, although this did not reach statistical significance.

Pre-treatment ^99mTc-DTPA dynamic renal scintigraphy GFR values and CRP levels are pivotal in assessing treatment efficacy for severe renal insufficiency secondary to UUTO, with the former being indispensable for evaluating compromised unilateral renal function.