Predicting Factors of Renal Recoverability Post Percutaneous Nephrostomy for Obstructive Uropathy in Universiti Kebangsaan Malaysia Medical Centre (UKMMC)

Abstract

Introduction: Multiple factors predict the recoverability of renal function post percutaneous nephrostomy (PCN) in obstructive uropathy. The aim is to ascertain parameters with significant predictive value to aid in the stratification of patients requiring urgent PCN. Materials and methods: A retrospective study over a period of 5 years between Jan uary 2016 till January 2021 was conducted in Universiti Kebangsaan Malaysia Medical Centre (UKMMC) involving a total of 217 patients who underwent image guided PCN that met the inclusion criteria. The pre-intervention renal imaging, biochemical parameters and the post-intervention serum creatinine were obtained and respective estimated glomerular filtration rate (eGFR) calculated. Patients with post-intervention serum creatinine of less than 130 umol/L and eGFR of more than 60 were categorized as patients with good renal recovery. Subsequently, the significance of each parameter with good renal recovery was analysed. Results: There is significant correlation between the absence of chronic kidney disease and renal parenchymal disease, level of obstruction, age, renal size, hemoglobin, pre-in tervention serum creatinine and eGFR with good renal recovery on bivariate analysis. However, only the absence of renal parenchymal disease, renal size of more than 11.2cm (S.D: 7.2 - 23.8) and pre-intervention eGFR of more than 23.0 (S.D: 2.2 - 168.0) remained statistically significant on multivariate analysis. Conclusion: Previous healthy kidneys with good size and function proves to be statistically significant in achieving the best recoverability which are applicable in stratification of PCN requests. A prospective study of a wider population will yield a farther accurate and generally pertinent result.