scholarly journals Challenges and management of laparoscopic treatment of pyonephrosis caused by calculi

2020 ◽  
Author(s):  
Jun Liu ◽  
Liang Chen ◽  
Lizhe An ◽  
Kai Ma ◽  
Xiongjun Ye ◽  
...  
Keyword(s):  
Renal Function ◽  
Clinical Data ◽  
Urothelial Cancer ◽  
Operation Time ◽  
Complete Loss ◽  
Dynamic Imaging ◽  
Laparoscopic Treatment ◽  
Transperitoneal Approach ◽  
Peking University ◽  
Endoscopic Lithotripsy

Abstract Background: Calculous pyonephrosis is a disease characterized by infectious hydronephrosis associated with pyogenic destruction of the renal parenchyma, with complete or almost complete loss of renal function.Methods: The clinical data of laparoscopic nephrolithotomy performed at Peking University People’s Hospital from May 2017 to June 2020 were analyzed retrospectively. Eight patients (2 men; 6 women) aged 27 to 65 years (average age, 45.8 years) were included. Among them, 7 patients were treated with retroperitoneal approach and 1 patient by transperitoneal approach. All patients had received more than one endoscopic lithotripsy before nephrectomy. Renal dynamic imaging and computed tomography revealed the absence of function in pyonephrosis before nephrectomy. General clinical data and perioperative data were recorded. All nephrectomies were performed by the same physician.Results: Laparoscopic surgery was successfully performed in 7 patients; however, 1 patient underwent open surgery because of bleeding. The operation time, average operation time, and blood loss were 1.5–4.5 hours, 3.4 hours, and 100–1000 ml (average, 300 ml), respectively. The postoperative pathology showed inflammatory renal disease in 6 patients, xanthogranulomatous pyelonephritis in 1 patient, and high-grade urothelial cancer in 1 patient. The average postoperative hospital stay was 4.4 days. None of the patients experienced severe complications and poor healing of endoscopic wounds.Conclusion: For patients with complicated calculous pyonephrosis, renal inflammation could not be effectively controlled, and renal function was seriously damaged. Thus, kidneys should be immediately resected. With laparoscopy, patients may recover quickly, but surgeons require enough experience when performing laparoscopy to achieve safety.

scholarly journals Challenges and management of laparoscopic treatment of pyonephrosis caused by calculi

2020 ◽  
Author(s):  
Jun Liu ◽  
Liang Chen ◽  
Lizhe An ◽  
Kai Ma ◽  
Xiongjun Ye ◽  
...  
Keyword(s):  
Renal Function ◽  
Clinical Data ◽  
Urothelial Cancer ◽  
Operation Time ◽  
Complete Loss ◽  
Dynamic Imaging ◽  
Laparoscopic Treatment ◽  
Transperitoneal Approach ◽  
Peking University ◽  
Endoscopic Lithotripsy

Abstract Background: Calculous pyonephrosis is a disease characterized by infectious hydronephrosis associated with pyogenic destruction of the renal parenchyma, with complete or almost complete loss of renal function.Methods: The clinical data of laparoscopic nephrolithotomy performed at Peking University People’s Hospital from May 2017 to June 2020 were analyzed retrospectively. Eight patients (2 men; 6 women) aged 27 to 65 years (average age, 45.8 years) were included. Among them, 7 patients were treated with retroperitoneal approach and 1 patient by transperitoneal approach. All patients had received more than one endoscopic lithotripsy before nephrectomy. Renal dynamic imaging and computed tomography revealed the absence of function in pyonephrosis before nephrectomy. General clinical data and perioperative data were recorded. All nephrectomies were performed by the same physician.Results: Laparoscopic surgery was successfully performed in 7 patients; however, 1 patient underwent open surgery because of bleeding. The operation time, average operation time, and blood loss were 1.5–4.5 hours, 3.4 hours, and 100–1000 ml (average, 300 ml), respectively. The postoperative pathology showed inflammatory renal disease in 6 patients, xanthogranulomatous pyelonephritis in 1 patient, and high-grade urothelial cancer in 1 patient. The average postoperative hospital stay was 5.3 days. One patient had a Clavien–Dindo Grade IIIb complication (severe hematuria), which required laparotomy, and was found that there was bleeding of ureteral stump. None of the patients experienced poor healing of endoscopic wounds.Conclusion: For patients with complicated calculous pyonephrosis, renal inflammation could not be effectively controlled, and renal function was seriously damaged. Thus, kidneys should be immediately resected. With laparoscopy, patients may recover quickly, but surgeons require enough experience when performing laparoscopy to achieve safety.

scholarly journals Challenges and management of laparoscopic treatment of pyonephrosis caused by calculi

2020 ◽  
Author(s):  
Jun Liu ◽  
Liang Chen ◽  
Lizhe An ◽  
Kai Ma ◽  
Xiongjun Ye ◽  
...  
Keyword(s):  
Renal Function ◽  
Clinical Data ◽  
Urothelial Cancer ◽  
Operation Time ◽  
Complete Loss ◽  
Dynamic Imaging ◽  
Laparoscopic Treatment ◽  
Transperitoneal Approach ◽  
Peking University ◽  
Endoscopic Lithotripsy

Abstract Background Calculous pyonephrosis is a disease characterized by infectious hydronephrosis associated with pyogenic destruction of the renal parenchyma, with complete or almost complete loss of renal function. Methods The clinical data of laparoscopic nephrolithotomy at Peking University People’s Hospital from May 2017 to December 2019 were analyzed retrospectively. Eight patients (2 men; 6 women) aged 27 to 65 years (average age, 42.2 years) were included. Among them, 7 patients were treated with retroperitoneal approach and 1 patient by transperitoneal approach. All patients had received more than one endoscopic lithotripsy before nephrectomy. Renal dynamic imaging and computed tomography revealed the absence of function in pyonephrosis before nephrectomy. General clinical data and perioperative data were recorded. All nephrectomies were performed by the same physician. Results Laparoscopic surgery was successfully performed in 7 patients; however, 1 patient underwent open surgery because of bleeding. The operation time, average operation time, and blood loss were 1.5–4.5 hours, 3.1 hours, and 100–1000 ml (average, 300 ml), respectively. The postoperative pathology showed inflammatory renal disease in 6 patients, xanthogranulomatous pyelonephritis in 1 patient, and high-grade urothelial cancer in 1 patient. The average postoperative hospital stay was 4.3 days. None of the patients experienced severe complications and poor healing of endoscopic wounds. Conclusion For patients with complicated calculous pyonephrosis, renal inflammation could not be effectively controlled, and renal function was seriously damaged. Thus, the kidneys should be immediately resected. With laparoscopy, patients may recover quickly, but surgeons require sufficient experience when performing laparoscopy to achieve safety.

scholarly journals Challenges and management of laparoscopic treatment of pyonephrosis caused by calculi

BMC Surgery ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Jun Liu ◽  
Liang Chen ◽  
Lizhe An ◽  
Kai Ma ◽  
Xiongjun Ye ◽  
...  
Keyword(s):  
Renal Function ◽  
Clinical Data ◽  
Urothelial Cancer ◽  
Operation Time ◽  
Complete Loss ◽  
Dynamic Imaging ◽  
Laparoscopic Treatment ◽  
Transperitoneal Approach ◽  
Peking University ◽  
Endoscopic Lithotripsy

Abstract Background Calculous pyonephrosis is a disease characterized by infectious hydronephrosis associated with pyogenic destruction of the renal parenchyma, with complete or almost complete loss of renal function. Methods The clinical data of laparoscopic nephrolithotomy performed at Peking University People’s Hospital from May 2017 to June 2020 were analyzed retrospectively. Eight patients (2 men; 6 women) aged 27 to 65 years (average age, 45.8 years) were included. Among them, 7 patients were treated with retroperitoneal approach and 1 patient by transperitoneal approach. All patients had received more than one endoscopic lithotripsy before nephrectomy. Renal dynamic imaging and computed tomography revealed the absence of function in pyonephrosis before nephrectomy. General clinical data and perioperative data were recorded. All nephrectomies were performed by the same physician. Results Laparoscopic surgery was successfully performed in 7 patients; however, 1 patient underwent open surgery because of bleeding. The operation time, average operation time, and blood loss were 1.5–4.5 h, 3.4 h, and 100–1000 ml (average, 300 ml), respectively. The postoperative pathology showed inflammatory renal disease in 6 patients, xanthogranulomatous pyelonephritis in 1 patient, and high-grade urothelial cancer in 1 patient. The average postoperative hospital stay was 5.3 days. One patient had a Clavien–Dindo Grade IIIb complication (severe hematuria), which required laparotomy, and was found that there was bleeding of ureteral stump. None of the patients experienced poor healing of endoscopic wounds. Conclusion For patients with complicated calculous pyonephrosis, renal inflammation could not be effectively controlled, and renal function was seriously damaged. Thus, kidneys should be immediately resected. With laparoscopy, patients may recover quickly, but surgeons require enough experience when performing laparoscopy to achieve safety.

Complete loss of unilateral renal function secondary to endometriosis: a report of three cases

2013 ◽  
Vol 171 (1) ◽  
pp. 132-137 ◽  
Author(s):  
Sara Arrieta Bretón ◽  
Ana López Carrasco ◽  
Alicia Hernández Gutiérrez ◽  
Roberto Rodríguez González ◽  
Javier de Santiago García
Keyword(s):  
Renal Function ◽  
Complete Loss

scholarly journals Creatinine‐Based Renal Function Assessment in Pediatric Drug Development: An Analysis Using Clinical Data for Renally Eliminated Drugs

2020 ◽  
Vol 109 (1) ◽  
pp. 263-269
Author(s):  
Yifei Zhang ◽  
Catherine M. Sherwin ◽  
Daniel Gonzalez ◽  
Qunshu Zhang ◽  
Mona Khurana ◽  
...  
Keyword(s):  
Renal Function ◽  
Drug Development ◽  
Clinical Data ◽  
Pediatric Drug ◽  
Pediatric Drug Development ◽  
Function Assessment

Impact of the CKD-EPI Equation for Estimating Renal Function on Eligibility for Cisplatin-based Chemotherapy in Patients With Urothelial Cancer

2012 ◽  
Vol 10 (1) ◽  
pp. 15-20 ◽  
Author(s):  
Che-Kai Tsao ◽  
Erin Moshier ◽  
Sonia M. Seng ◽  
James Godbold ◽  
Steven Grossman ◽  
...  
Keyword(s):  
Renal Function ◽  
Urothelial Cancer

scholarly journals The Application of 99mTc-DTPA Renal Dynamic Imaging to Measuring Renal Function of Children with Acute Lymphoblastic Leukemia after Induction Therapy

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Lidan Wang ◽  
Kailan Chen ◽  
Qiong Xu
Keyword(s):  
Renal Function ◽  
Acute Lymphoblastic Leukemia ◽  
Induction Therapy ◽  
Estimated Glomerular Filtration Rate ◽  
Lymphoblastic Leukemia ◽  
Kidney Injury ◽  
Binary Logistic Regression ◽  
Dynamic Imaging ◽  
High Dose ◽  
Renal Functions

Purpose. The study was aimed at assessing renal functions of children with acute lymphoblastic leukemia (ALL) after induction therapy by 99mTc-DTPA renal dynamic imaging Gates method (GFRGates) and investigating whether renal function after induction therapy will affect the occurrence of high-dose methotrexate- (HDMTX-) induced acute kidney injury (AKI). Methods. Children with newly diagnosed ALL were enrolled. Renal functions before the administration of HDMTX were assessed by estimated glomerular filtration rate (eGFR) and GFRGates, respectively, before the first cycle of HDMTX after induction therapy. The areas under the ROC curve were used to assess covariates’ ability to predict HDMTX-induced AKI. Results. 102 children with ALL were included in the study. A stepwise backward binary logistic regression showed that only standardized GFRGates was an independent risk factor for HDMTX-induced AKI ( p = 0.018 , odds ratio 0.985, 95% CI 0.972-0.997). The area under the ROC of standardized GFRGates was 0.679 ( p = 0.012 , 95% CI 0.554-0.804). Conclusion. Standardized GFRGates showed that the normal renal function of children is not enough to be used as a cutoff point to predict HDMTX-induced AKI in ALL children receiving HDMTX. More attention and supportive care should be given to the children with standardized GFRGates lower than the cutoff value to avoid the HDMTX-induced AKI.

scholarly journals A Novel Creatinine-Based Equation to Estimate Glomerular Filtration Rate in Chinese Population With Chronic Kidney Disease: Implications for DOACs Dosing in Atrial Fibrillation Patients

2021 ◽  
Vol 12 ◽  
Author(s):  
Ling-Yun Zhou ◽  
Wen-Jun Yin ◽  
Jun Zhao ◽  
Bi-Kui Zhang ◽  
Can Hu ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Chronic Kidney Disease ◽  
Renal Function ◽  
Glomerular Filtration Rate ◽  
Kidney Disease ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Linear Regression Analysis ◽  
Dynamic Imaging ◽  
Adverse Outcomes

Background: Over/under-estimating renal function may increase inappropriate dosing strategy associated adverse outcomes; however, previously reported equations to estimate renal function have limited accuracy in chronic kidney disease (CKD) patients. Consequently, we intended to develop a novel equation to precisely estimate renal function and subsequently guide clinical treatment for CKD patients.Methods: A novel approach, Xiangya-s equation, to estimate renal function for CKD patients was derived by linear regression analysis and validated in 1885 patients with measured glomerular filtration rate (mGFR) < 60 ml/min/1.73 m2 by renal dynamic imaging at three representative hospitals in China, with the performance evaluated by accuracy, bias and precision. In the meanwhile, 2,165 atrial fibrillation (AF) patients who initiated direct oral anticoagulants (DOACs) between December 2015 and December 2018 were identified and renal function was assessed by estimated creatinine clearance (eCrCl). Events per 100 patient-years was calculated. Cox proportional hazards regression was applied to compare the incidence of outcomes of each group.Results: Xiangya-s equation demonstrated higher accuracy, lower bias and improved precision when compared with 12 creatinine-based and 2 CysC-based reported equations to estimate GFR in multi-ethnic Chinese CKD patients. When we applied Xiangya-s equation to patients with AF and CKD prescribed DOACs, wide variability was discovered in eCrCl calculated by the Cockcroft-Gault (CG), Modification of Diet in Renal Disease Study (MDRD), Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI), Xiangya equation which we had developed for generally patients and Xiangya-s equations, which persisted after grouping by different renal function stages. Equation choice affected drug-dosing adjustments, with the formulas agreeing for only 1.19%, 5.52%, 33.22%, 26.32%, and 36.61% of potentially impacted patients for eCrCl cutoffs of <15, <30, 15–49, 30–49, ≥50 ml/min, respectively. Relative to CG equation, accordance in DOACs dosage was 81.08%, 88.54%, 62.25%, and 47.68% for MDRD, CKD-EPI, Xiangya and Xiangya-s equations for patients with CrCl < 50 ml/min (eCrCl cutoffs of <30, 30–49, ≥50 ml/min), respectively. Reclassification of renal function stages by Xiangya-s equation was significantly associated with stroke or systemic embolism, non-major clinically relevant bleeding and any bleeding events.Conclusion: Xiangya-s equation provides more accurate GFR estimates in Chinese CKD patients who need consecutive monitoring of renal function, which may assist clinicians in choosing appropriate drug dosages.

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