Effects of Urinary Tract Obstruction on Renal Function

Partial or complete obstruction of the urinary tract is a common and challenging urological condition caused by a variety of conditions, including ureteral calculi, ureteral pelvic junction obstruction, ureteral stricture, and malignant ureteral obstruction. The condition, which may develop in patients of any age, induces tubular and interstitial injury followed by inflammatory cell infiltration and interstitial fibrosis, eventually impairing renal function. The serum creatinine level is commonly used to evaluate global renal function but is not sensitive to early changes in the glomerular filtration rate and unilateral renal damage. Biomarkers of acute kidney injury are useful for the early detection and monitoring of kidney injury induced by upper urinary tract obstruction. These markers include levels of neutrophil gelatinase-associated lipocalin (NGAL), monocyte chemotactic protein-1, kidney injury molecule 1, N-acetyl-b-D-glucosaminidase, and vanin-1 in the urine and serum NGAL and cystatin C concentrations. This review summarizes the pathophysiology of kidney injury caused by upper urinary tract obstruction, the roles played by emerging biomarkers of obstructive nephropathy, the mechanisms involved, and the clinical utility and limitations of the biomarkers.

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Urinary tract obstruction

Oxford Textbook of Medicine ◽

10.1093/med/9780199204854.003.2117 ◽

2010 ◽

pp. 4151-4161

Author(s):

Muhammad M. Yaqoob ◽

Islam Junaid

Keyword(s):

Renal Function ◽

Urinary Tract ◽

Renal Pelvis ◽

Urinary Tract Obstruction ◽

Obstructive Nephropathy ◽

Characteristic Finding ◽

Pelvicalyceal System ◽

Outflow System

Obstructive nephropathy can manifest as either a sudden or an insidious decline in renal function, which can be can halted or even reversed by relief of obstruction. Obstruction can be due to anatomical or functional abnormalities of the urethra, bladder, ureter, or renal pelvis, which may be congenital or acquired, and it can also occur as a consequence of diseases extrinsic to the urinary tract. Although dilatation of the outflow system proximal to the site of obstruction is a characteristic finding, widening of the ureter and/or pelvicalyceal system does not necessarily indicate the presence of obstruction, and flow may be obstructed without such dilatation....

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Antenatal Ultrasound to Predict Postnatal Renal Function in Congenital Lower Urinary Tract Obstruction

Ultrasound Quarterly ◽

10.1097/01.ruq.0000377238.02936.8c ◽

2010 ◽

Vol 26 (2) ◽

pp. 118

Author(s):

Carolyn M. Sofka

Keyword(s):

Renal Function ◽

Urinary Tract ◽

Lower Urinary Tract ◽

Urinary Tract Obstruction ◽

Antenatal Ultrasound ◽

Lower Urinary Tract Obstruction ◽

Lower Urinary

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Acute Urinary Tract Obstruction

Serbian Journal of Experimental and Clinical Research ◽

10.1515/sjecr-2015-0033 ◽

2015 ◽

Vol 16 (3) ◽

pp. 249-253

Author(s):

Djordje Aleksic

Keyword(s):

Primary Care ◽

Emergency Medicine ◽

Renal Function ◽

Urinary Tract ◽

Primary Care Physicians ◽

Bladder Dysfunction ◽

Urinary Tract Obstruction ◽

The Body ◽

Bottom Line ◽

Common Causes

AbstractThe kidneys are paired organs with the primary function of helping to remove toxins from the body and regulate water balance. They are vital to survival. After urine is produced in the kidneys, it must pass into the bladder, where it can be stored before being eliminated from the body through the urethra. Urinary tract obstruction is a common problem encountered by urologists, primary care physicians, and emergency medicine physicians. Urine can become obstructed at any point in this pathway. There are three groups of urinary tract obstructions: 1) obstruction of the urinary tract lumen; 2) obstruction of the urinary tract wall; and 3) extrinsic obstruction, which can press on the urinary tract lumen. An obstruction can be present from birth or develop later in life. The most common causes of obstruction include stones, strictures, tumours, and bladder dysfunction. These obstructions may result in the hydronephrosis of one or both kidneys, which, if left untreated, may lead to the deterioration of renal function. The goal of an initial treatment of urinary tract obstruction is to remove the obstruction. Later, we treat the cause that led to the obstruction. The bottom line is that all efforts should be made to preserve kidney function to avoid the need for dialysis or renal transplantation.

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