Renal Decline Is Unusual After Obstruction Relief
Progressive deterioration in renal function is unusual following relief of obstructive nephropathy in most patients over a three-year period, according to British researchers.
Rommel Ravanan, MD, of University Hospital of Wales in Cardiff, and Charles R.V. Tomson, MD, of Southmead Hospital in Bristol, studied 104 patients who presented with obstructive nephropathy and renal impairment in a tertiary renal unit and who had successful treatment of the obstruction. At 12 months, nine deaths had occurred; at three years, another four deaths had occurred.
The mean glomerular filtration rate (GFR) at presentation was 9.2 mL/min per 1.73 m2. At three, 12, and 36 months, it was 27.8, 29.0, and 30 mL/min per 1.73 m2, respectively. Of 28 patients initially requiring dialysis, six were dialysis-dependent at three months. Another three patients, all with a GFR less than 10 mL/min per 1.73 m2 following relief of obstruction, required dialysis at 12 months. One patient required dialysis at 36 months.The investigators observed that the “relative stability in human postobstructive nephropathy contrasts with the course of remnant nephropathy in animal models.”