Does relative renal function improve after intervention for chronic ureteric obstruction?
BAUS ePoster online library. Low Z. Jun 25, 2019; 259478; P11-4
Zhi-Yang Low
Zhi-Yang Low
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INTRODUCTION: Unilateral renal function often deteriorates with chronic ureteric obstruction. Our objectives were to determine the change in relative renal function (RRF) by MAG3 renography after intervention for ureteric obstruction, and to identify any clinical/epidemiological factors which influence long-term outcomes.

We identified 281 patients who had MAG3 renography before and after intervention for unilateral ureteric obstruction. Patients were divided into categories with normal preoperative RRF (43-57%), mild (29-42%), moderate (15-28%) and severe (<15%) impairment of preoperative RRF in the affected kidney. Patient demographics, type of obstructive uropathy and type of intervention employed were analysed. Each group was assessed both for the absolute change in RRF and change in RRF category postoperatively.

The mean patient age (SD) was 50.2 (16.4) with 61.6% being female. Overall, the mean pre- and postoperative RRF did not differ significantly (31.69 [14.0]% vs 30.75 [15.4]%, P=0.07). The majority of patients remained in their preoperative RRF group: 82.3% of normal, 67.7% of mild, 66.7% of moderate and 80.4% of patients with severe RRF impairment, as shown in Figure 1.

Patients with mildly impaired preoperative RRF showed a significant worsening postoperatively (36.27% vs 33.92%, P=0.006). The other three groups showed no significant change in RRF postoperatively.

Multivariate logistic regression analysis showed receiving a nephrostomy (OR 10.52, 95% CI 1.60-69.13) was a positive predictor of improvement in RRF category postoperatively.

Our results show that RRF does not improve significantly after intervention for ureteric obstruction. The aim should therefore be maintaining existing renal function and relieving symptoms.
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