Renal function in patients with hydronephrosis

Area of Science:

• Urology
• Nephrology

Background:

• Hydronephrosis secondary to pelvic-ureteric junction obstruction is a common condition.
• Assessing the long-term impact on renal function is crucial for treatment decisions.

Purpose of the Study:

• To re-evaluate glomerular filtration rate and pelvic drainage function in patients with hydronephrosis.
• To determine the long-term outcomes of surgical versus non-surgical management of pelvic-ureteric junction obstruction.

Main Methods:

• Longitudinal study of 50 patients with hydronephrosis.
• Investigated glomerular filtration rate using clearance techniques and isotope renography.
• Compared outcomes in patients who underwent pyeloplasty, those not operated upon, and those who had nephrectomy.

Main Results:

• 16/28 kidneys after pyeloplasty and 11/12 non-operated kidneys showed normal renal parenchymal function despite drainage issues.
• Renal function remained stable in 11 non-operated patients; one showed deterioration likely due to pyelonephritis.
• Pyeloplasty (Anderson-Hynes technique) was performed on 28 kidneys; 10 had nephrectomy.

Conclusions:

• Uncomplicated pelvic-ureteric junction obstruction may not necessitate surgery unless symptomatic.
• A conservative approach with regular monitoring is recommended for asymptomatic cases.
• Yearly renal function tests and imaging are advised for patients with pelvic-ureteric junction obstruction.