Management outcome of obstructed kidney disease due to stones: experience from Gezira hospital for renal disease and surgery, Sudan

  • Authors

    • Nadir I A Fadol
    • Mohmmed E Mohammed
    • Sami M Taha
    • Mohamed D Awadalla Gismalla Department of surgery faculty of medicine , Gezira University
    2017-02-11
    https://doi.org/10.14419/ijm.v5i1.7219
  • Renal Stone, Ureteric Stone, Obstructive Nephropathy.

  • Background: Obstructive nephropathy which caused by stones is a burden problem in developing countries associated with late presentation and a lot of complications.

    Objective: This study was done to evaluate the outcome of management of obstructed kidney due to stones at Gezira hospital for renal disease & surgery.

    Material and Methods: This is prospective cross-sectional hospital-based study. All patients who presented with obstructed kidneys and fulfill the criteria were included. Constructed flow chart was used to collect data. Then data was analyzed to detect the dependent & independent variable. Relation with P-value <0.05 are considered significantly.

    Result: 140 patients are included. Duration of Presenting symptoms was 9 weeks or more in 99 patients, 5-8 weeks in 11 patients, 2-4 weeks in 6 patients, and less than two weeks in 30 patients. It is strongly related to post-intervention serum creatinine (P-value =0.009).

    Common site of stone is ureter (58 patients) and renal pelvis (54 patients) significantly associated with recovery (P-value 0.009). An urgent intervention was done to 69 patients. Definitive treatments were Open surgery, endoscopic procedure (URS), or both with rate 65(46.4%), 57 (40.7%), and 10(7.2%) respectively. In 5.7% (n= 8 patients) endoscopic procedure (URS) was failed. Postoperative follow up (after 6 weeks or after removal of stent) 95.7 % (n=134 patients) were free from symptoms, and there were no clinical signs in all patients post intervention.

    Conclusion: late presentation and site of obstructed kidney stone can predict the complication and affect the outcome.

  • References

    1. [1] Abdelraheem M, Ali E T, Osman R, Ellidir R, Bushara A, Hussein R & Abu-Aisha H (2014) Outcome of acute kidney injury in sudanese children—an experience from a sub-Saharan African unit. Peritoneal Dialysis International, 34(5), 526-533. https://doi.org/10.3747/pdi.2013.00082.

      [2] Alexander R T, Hemmelgarn B R, Wiebe N, Bello A, Morgan C, Samuel S& Tonelli M (2012) Kidney stones and kidney function loss: a cohort study. https://doi.org/10.1136/bmj.e5287.

      [3] Bihl G, & Meyers a (2001) recurrent renal stone disease—advances in pathogenesis and clinical management. The Lancet, 358(9282), 651-656. https://doi.org/10.1016/S0140-6736(01)05782-8.

      [4] Elsharif M E, & Elsharif E G (2011) Causes of end-stage renal disease in Sudan: A single-center experience. Saudi Journal of Kidney Diseases and Transplantation, 22(2), 373-376.http://www.sjkdt.org/text.asp?2011/22/2/373/77650

      [5] ElSheemy M S, Shouman A M, Shoukry A I, ElShenoufy A, Aboulela W, Daw K &Badawy H (2015) Ureteric stents vs percutaneous nephrostomy for initial urinary drainage in children with obstructive anuria and acute renal failure due to ureteric calculi: a prospective, randomised study. BJU international, 115(3), 473-479. https://doi.org/10.1111/bju.12768.

      [6] Fasihuddin Q &Hasan A T (2002) Ureteroscopy (URS): an effective interventional and diagnostic modality. JPMA. The Journal of the Pakistan Medical Association, 52(11), 510-512.

      [7] Fwu C W, Eggers P W, Kimmel P L, Kusek J W, &Kirkali Z (2013) Emergency department visits, use of imaging, and drugs for urolithiasis have increased in the United States. Kidney international, 83(3), 479-486. https://doi.org/10.1038/ki.2012.419.

      [8] Glowacki L S, Beecroft M L, Cook R J, Pahl D & Churchill D N (1992) The natural history of asymptomatic urolithiasis. The Journal of urology, 147(2), 319-321.

      [9] Honeck P, Wendt-Nordahl G, Krombach P, Bach T, Häcker A, Alken P, & Michel M S (2009) Does open stone surgery still play a role in the treatment of urolithiasis? Data of a primary urolithiasis center. Journal of Endourology, 23(7), 1209-1212. https://doi.org/10.1089/end.2009.0027.

      [10] Kambal A, Wahab E M, &Khattab A H (1979) Urolithiasis in Sudan. Geographical distribution and the influence of climate. Tropical and geographical medicine, 31(1), 75-79.

      [11] Lieske J C, De La Vega L P, Slezak J M, Bergstralh E J, Leibson C L, Ho K L &Gettman M T. (2006). Renal stone epidemiology in Rochester, Minnesota: an update. Kidney international, 69(4), 760-764. https://doi.org/10.1038/sj.ki.5000150.

      [12] Menon M (1998) Urinary lithiasis: etiology, diagnosis, and medical management. Campbell's urology. In: Walsh PC, editor. Campbell’s Urology. 7th edition, Philadelphia: Saunders, pp. 2661–2733.

      [13] Pearle M S, Calhoun E A, Curhan, G C & Urologic Diseases of America Project. (2005). Urologic diseases in America project: urolithiasis. The Journal of urology, 173(3), 848-857. https://doi.org/10.1097/01.ju.0000152082.14384.d7.

      [14] Prstojevic J K, Junuzovic D, Hasanbegovic M, Lepara Z, &Selimovic M (2014) Characteristics of Calculi in the Urinary Tract. Materia socio-medica, 26(5), 297-302 https://doi.org/10.5455/msm.2014.26.297-302.

      [15] Scales C D, Curtis L H, Norris R D, Springhart W P, Sur R L, Schulman K A & Preminger G M (2007) Changing gender prevalence of stone disease. The Journal of urology, 177(3), 979-982. https://doi.org/10.1016/j.juro.2006.10.069.

      [16] Stamatelou K K, Francis M E, Jones C A, Nyberg L M, &Curhan G C (2003) Time trends in reported prevalence of kidney stones in the United States: 1976–19941. Kidney international, 63(5), 1817-1823. https://doi.org/10.1046/j.1523-1755.2003.00917.x.

      [17] Soucie J M, Thun M J, Coates R J, McClellan W, & Austin H (1994) Demographic and geographic variability of kidney stones in the United States. Kidney international, 46(3), 893-899. https://doi.org/10.1038/ki.1994.347.

      [18] Teichman J M, Long R D, & Hulbert J C (1995) Long-term renal fate and prognosis after staghorn calculus management. The Journal of urology, 153(5), 1403-1407. https://doi.org/10.1016/S0022-5347(01)67413-5.

      [19] Wilkinson H (2001) Clinical investigation and management of patients with renal stones. Annals of clinical biochemistry, 38, 180-187. https://doi.org/10.1258/0004563011900623.

  • Downloads

  • How to Cite

    Fadol, N. I. A., Mohammed, M. E., Taha, S. M., & Gismalla, M. D. A. (2017). Management outcome of obstructed kidney disease due to stones: experience from Gezira hospital for renal disease and surgery, Sudan. International Journal of Medicine, 5(1), 52-55. https://doi.org/10.14419/ijm.v5i1.7219