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Renal parenchymal thickness and urinary protein levels in patients with ureteropelvic junction obstruction after nephrostomy placement
Author(s) -
Deng GaoYan,
Sun JunJie,
Wang Pa,
Mo JiaCong
Publication year - 2010
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1111/j.1442-2042.2010.02448.x
Subject(s) - medicine , urinary system , hydronephrosis , urology , nephrostomy , renal function , creatinine , percutaneous nephrostomy , parenchyma , kidney , beta 2 microglobulin , pathology , percutaneous
Objective: To assess recovery of renal parenchymal thickness and urinary protein levels in patients with severely hydronephrotic kidneys after nephrostomy placement. Methods: Fourteen patients (median age 1 year, range 6 months–7 years) who underwent nephrostomy placement for unilateral ureteropelvic junction obstruction at our hospital between May 2007 and January 2009 were included in a retrospective analysis. All patients had severe hydronephrosis, with a median parenchymal thickness of 1.8 mm (range 1–2.5 mm). Kidney morphology was examined by ultrasound before the procedure and 1, 2, 3, 4, 6 and 8 weeks after. Urinary proteins (including albumin, immunoglobulin [IgG], α2‐macroglobulin, α1‐microglobulin, β2‐microglobulin [β2‐MG] and kappa chain) and creatinine levels were also tested during these follow‐up visits. Fifteen healthy children were assessed for urinary protein levels as well and made up the control group. Results: Parenchymal thickness increased within 4 weeks of nephrostomy placement. Kidney volumes were significantly decreased within 2 weeks. No further changes in morphology were detected after 4 weeks. Urinary α1‐microglobulin and β2‐MG levels decreased to baseline within 1 and 4 weeks, respectively. Urinary albumin, IgG, α2‐macroglobulin and kappa chain levels decreased gradually after nephrostomy, but did not return to baseline within 8 weeks. Conclusions: After nephrostomy placement, parenchymal thickness increases within 4 weeks, tubular function returns to normal earlier than glomerular function and glomerular membrane repair is inversely correlated with the severity of damage.