Abstract：
UNASSIGNED: Obstructive uropathy encompasses various urinary tract obstructions, leading to changes in urine flow, kidney pressure, and impaired kidney function. Predicting renal recovery from obstructive uropathy, can be challenging and necessitates treatment, as in percutaneous nephrostomy (PNS) drainage. The choice of drainage method depends on patient-specific factors and local expertise. According to the data for the Republic of North Macedonia, in the register of the European Renal Association, in the last few years, there has been an increase in the percentage of patients with obstructive nephropathy from 7.6% to 8.9% who end up on a chronic hemodialysis program. Prompt relief from urinary tract obstruction is essential to preserve renal function and prevent complications. The aim of this study is to present our initial data analysis of recent experience in the use of nephrostomies as a method for temporary or long-term resolution of obstructive nephropathy, in terms of safety and success in preserving kidney function and reducing the number of patients on hemodialysis.
UNASSIGNED: This study analyzed the medical records of 24 patients with obstructive uropathy who underwent PNS placement. Data were collected for the type and degree of obstruction from the ultrasonographic examination. A pig tail nephrostomy was used, with a dilator, guided under ultrasound and controlled with contrast and fluoroscope. Obstructive nephropathy was defined as an elevation of the serum creatinine > 109 µmol/L, before the intervention. Glomerular filtration rate (GFR) was calculated according to the formula CKD epi in ml/min. Each placement of the PNS was considered as an individual procedure and the data of 38 placed nephrostomies were analyzed. We compared the laboratory analyses from the day before (D0) PNS placement and on the seventh day (D7) after PNS placement. The reduction of values for red blood cells (RBC) and hemoglobin (Hb) baseline values from D0 to D7 and the need for transfusion after the procedure were defined as a complication-bleeding. The increase in total counts of the white blood cells (WBC) and C-reactive protein (CRP) from the baseline values from D0 to D7 were defined as a complication-infection. Standard statistical methods were used for data processing.
UNASSIGNED: Most patients, 17 (70%), had malignant disease as the cause of obstruction. Unilateral obstruction was more common, detected in 24 (63%) of procedures, with a high degree of hydronephrosis. Obstructive nephropathy, marked by elevated serum creatinine, was observed in 23 (60%) cases before PNS placement. Complications included bleeding and infection but did not result in any fatalities. When comparing the laboratory analysis before PNS placement (D0) and seven days later (D7), a statistically significant decrease in serum creatinine (225±161 vs. 162±145, p=0.005) and an increase in GFR (47±39 vs.59±34, p= 0.005) were observed.
UNASSIGNED: Percutaneous nephrostomy is a safe and effective treatment option for urinary tract obstruction, especially in patients with malignancies. Continuous monitoring is essential to assess long-term complications and the longevity of PNS functionality. This procedure offers a significant benefit in preserving renal function and minimizing the need for hemodialysis in these patients.
UNASSIGNED: This study analyzed the medical records of 24 patients with obstructive uropathy who underwent PNS placement. Data were collected for the type and degree of obstruction from the ultrasonographic examination. A pig tail nephrostomy was used, with a dilator, guided under ultrasound and controlled with contrast and fluoroscope. Obstructive nephropathy was defined as an elevation of the serum creatinine > 109 µmol/L, before the intervention. Glomerular filtration rate (GFR) was calculated according to the formula CKD epi in ml/min. Each placement of the PNS was considered as an individual procedure and the data of 38 placed nephrostomies were analyzed. We compared the laboratory analyses from the day before (D0) PNS placement and on the seventh day (D7) after PNS placement. The reduction of values for red blood cells (RBC) and hemoglobin (Hb) baseline values from D0 to D7 and the need for transfusion after the procedure were defined as a complication-bleeding. The increase in total counts of the white blood cells (WBC) and C-reactive protein (CRP) from the baseline values from D0 to D7 were defined as a complication-infection. Standard statistical methods were used for data processing.
UNASSIGNED: Most patients, 17 (70%), had malignant disease as the cause of obstruction. Unilateral obstruction was more common, detected in 24 (63%) of procedures, with a high degree of hydronephrosis. Obstructive nephropathy, marked by elevated serum creatinine, was observed in 23 (60%) cases before PNS placement. Complications included bleeding and infection but did not result in any fatalities. When comparing the laboratory analysis before PNS placement (D0) and seven days later (D7), a statistically significant decrease in serum creatinine (225±161 vs. 162±145, p=0.005) and an increase in GFR (47±39 vs.59±34, p= 0.005) were observed.
UNASSIGNED: Percutaneous nephrostomy is a safe and effective treatment option for urinary tract obstruction, especially in patients with malignancies. Continuous monitoring is essential to assess long-term complications and the longevity of PNS functionality. This procedure offers a significant benefit in preserving renal function and minimizing the need for hemodialysis in these patients.
摘要：
■梗阻性尿路病包括各种尿路阻塞，导致尿流的变化，肾压,肾功能受损.预测阻塞性尿路病变的肾脏恢复，可能是具有挑战性的，需要治疗，如在经皮肾造口术（PNS）引流中。引流方法的选择取决于患者的具体因素和当地的专业知识。根据北马其顿共和国的数据，在欧洲肾脏协会的登记册中，在过去的几年里，最终接受慢性血液透析治疗的阻塞性肾病患者比例从7.6%上升至8.9%.迅速缓解尿路梗阻对于保持肾功能和预防并发症至关重要。这项研究的目的是提供我们对使用肾造口术作为暂时或长期解决阻塞性肾病的方法的最新经验的初步数据分析。在保护肾功能和减少血液透析患者数量方面的安全性和成功率。
■本研究分析了24例接受PNS置入的梗阻性尿路病患者的医疗记录。从超声检查中收集阻塞的类型和程度的数据。使用了猪尾肾造口术，用扩张器,在超声引导下，用对比和荧光镜控制。阻塞性肾病定义为血清肌酐升高>109µmol/L，在干预之前。根据公式CKDepi以ml/min计算肾小球滤过率(GFR)。将PNS的每次放置视为单独的程序，并分析了38个放置的肾造口的数据。我们比较了PNS放置前一天（D0）和PNS放置后第七天（D7）的实验室分析。红细胞（RBC）和血红蛋白（Hb）基线值从D0降低到D7，以及手术后需要输血被定义为并发症出血。从D0到D7，白细胞（WBC）和C反应蛋白（CRP）的总计数从基线值增加被定义为并发症感染。使用标准统计方法进行数据处理。
■大多数患者，17（70%），有恶性疾病作为梗阻的原因。单侧梗阻更常见，在24例（63%）的程序中检测到，高度肾积水.阻塞性肾病,以血清肌酐升高为标志，在PNS放置前观察到23例(60%)。并发症包括出血和感染，但未导致任何死亡。当比较PNS放置前(D0)和7天后(D7)的实验室分析时，血清肌酐有统计学意义的下降(225±161vs.162±145，p=0.005）和GFR增加（47±39vs.59±34，p=0.005）。
■经皮肾造瘘术是治疗尿路梗阻的一种安全有效的选择，尤其是恶性肿瘤患者。持续监测对于评估长期并发症和PNS功能的寿命至关重要。该程序在保留这些患者的肾功能和最大程度地减少对血液透析的需求方面提供了显着益处。
■本研究分析了24例接受PNS置入的梗阻性尿路病患者的医疗记录。从超声检查中收集阻塞的类型和程度的数据。使用了猪尾肾造口术，用扩张器,在超声引导下，用对比和荧光镜控制。阻塞性肾病定义为血清肌酐升高>109µmol/L，在干预之前。根据公式CKDepi以ml/min计算肾小球滤过率(GFR)。将PNS的每次放置视为单独的程序，并分析了38个放置的肾造口的数据。我们比较了PNS放置前一天（D0）和PNS放置后第七天（D7）的实验室分析。红细胞（RBC）和血红蛋白（Hb）基线值从D0降低到D7，以及手术后需要输血被定义为并发症出血。从D0到D7，白细胞（WBC）和C反应蛋白（CRP）的总计数从基线值增加被定义为并发症感染。使用标准统计方法进行数据处理。
■大多数患者，17（70%），有恶性疾病作为梗阻的原因。单侧梗阻更常见，在24例（63%）的程序中检测到，高度肾积水.阻塞性肾病,以血清肌酐升高为标志，在PNS放置前观察到23例(60%)。并发症包括出血和感染，但未导致任何死亡。当比较PNS放置前(D0)和7天后(D7)的实验室分析时，血清肌酐有统计学意义的下降(225±161vs.162±145，p=0.005）和GFR增加（47±39vs.59±34，p=0.005）。
■经皮肾造瘘术是治疗尿路梗阻的一种安全有效的选择，尤其是恶性肿瘤患者。持续监测对于评估长期并发症和PNS功能的寿命至关重要。该程序在保留这些患者的肾功能和最大程度地减少对血液透析的需求方面提供了显着益处。
