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Year : 1996  |  Volume : 12  |  Issue : 2  |  Page : 65-70

Prediction of functional outcome in poorly functioning kidneys with unilateral pelviureteric junction obstruction : analysis of clinical features and lsotope renography.


Department of Vrology, Sanjay Gundhi Post Graduate Institute of Medical Sciences, Lucknow

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R Babu
Department of Vrology, Sanjay Gundhi Post Graduate Institute of Medical Sciences, Lucknow

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Source of Support: None, Conflict of Interest: None


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In an attempt to predict the recovery of function following relief of pelviureteric juction obstruction (PUJO) in poorly functioning kidneys (split GFR 20 ml/min), clinical parameters viz. age, history of pyelohephritis, palpable mass and the preoperative renogram data (perfusion status, ipsilateral and contralateral GFR) of 48 patients with unilateral PUJO with poorly functioning ipsilateral kidney were noted. Function was assessed with 99m-Tc-Diethylene Triamine Penta Acetic acide renogram (DTPA-renogram) following relief of obstruction. Recovery of function was defined as more than 10 percent increase in baseline split GFR. Statistical analysis of the preoperative parameters was done in 41 evaluable patients with multiple logistic regression analysis. Function of the affected kidney improved in 20 (53 percent), remained static in 15 and deteriorated in 3. Age till 15 years and presence of mass predicated functional recovery while history of pyelonephritis adversely affected the functional outcome. Presence or absence of pain, functional status of the aggected and contalateral kidney and perfusion status of the affected and contralateral kidney and perfusion status of the affected and contralateral kidney and perfusion staus of the affected kidney on DTPA renogram had no effect on the functional outcome. Younger patients (age till 15 years) with palpable mass in the absence of pyelonephritis may be offered salvage surgery without interposing PCN in between irrespective of the residual function of the affected kidney. Renogram parameters in these poorly functioning kidneys did not have any correlation with the functional outcome.


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