Reversibility of glomerular filtration rate after surgery for unilateral obstructive Uropathy

Abstract

Introduction: Surgical treatment is increasingly finding a place in the treatment of unilateral obstructive uropathy. This study was designed to investigate the recoverability of renal function following surgical treatment of adult patients with unilateral obstructive uropathy using Lasix 99mTc-diethylenetriaminepentaacetate renography (DTPA-R) for measurement of glomerular filtration rate (GFR) before and after surgery. Methods: This was a prospective study which included 29 (20 males and 9 females) consecutive adult patients with a diagnosis of unilateral renal obstruction and a normal contralateral kidney. The obstruction and malfunction of the contralateral kidney were confirmed with Lasix DTPA-R. For all the patients, surgical treatment of the unilateral kidney obstruction was performed, and post-surgical measurement of the function of the treated kidney was also applied using Lasix DTPA-R. Results: The mean age of the patients was 42.24 years. According to our results, the average of pre-operation GFR was 17.48 ± 9.10 ml/minute/1.73 m2 and post-operation GFR was 26.4 ± 11.2 ml/minute/1.73 m2. It is approved that the GFR increased 8.92 ± 6.30 ml/minute/1.73 m2 after surgery. The most increased rate of GFR was observed in the group with the impaired kidney with GFR > 20 ml/minute. It is approved that the rate of recovery in the patients with preoperational total GFR > 75 ml/minute and also 50 < GFR < 75 ml/minute was more than that in the other patients. Conclusion: Our findings demonstrated that in unilateral obstructive uropathy if the GFR of the impaired kidney is > 10 ml/minute/1.73 m2 or total GFR > 25 ml/minute/1.73 m2 the functional recovery of damaged kidney could be expected following the removal surgery.

Keywords: Unilateral Obstructive, Uropathy, Kidney Function, Reversibility, Surgical Treatment