Effect of Nephrostomy on Relative Function of Obstructed Kidney

NCT ID: NCT03936673

Last Updated: 2019-05-03

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

18 participants

Study Classification

INTERVENTIONAL

Study Start Date

2014-07-01

Study Completion Date

2019-01-01

Brief Summary

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Urinary tract obstruction is a serious health problem due to kidney damage. Relative renal function has an important role in the treatment of obstructed kidneys. Nephrectomy can be recommended when the relative renal function is 10% or less in radionuclide examinations. Recently, however, nephron sparing approaches have come to the fore. This indicated the need to evaluate the possibility of recovering the function of the kidney before nephrectomy. The aim of this study is to compare relative functions of obstructed kidneys in technetium 99m dimercaptosuccinic acid scintigraphy (DMSA) before and 2 weeks after nephrostomy tube.

Detailed Description

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Obstructive uropathy is one of the most important causes of acute renal injury and end-stage renal failure. obstruction of urine flow increases the intratubular pressure. This pressure increase causes decrease in renal blood flow and starts the inflammatory process. In the first few hours after total ureter obstruction, due to the increase in intratubular pressure glomerular filtration ceases and tubular transport is markedly decreased. Long lasting obstruction results in renal fibrosis and end stage renal damage. Basically obstructive uropathy leading to irreversible renal damage and loss of renal function is the main indication for simple nephrectomy. Serious renal parenchymal damage is defined as non-functioning kidney having relative renal function (RRF) 10% or less in the literature. But recently in some studies it was suggested that by applying the nephrostomy catheter, ability of kidney to regain function can be evaluated before nephrectomy. So, possibility of gaining function should be kept in mind. In this study effect of percutaneous nephrostomy tube on serum creatinine, blood urea nitrogen (BUN) and RRF in obstructed kidney with RRF 10% or less. Before and 2 weeks after percutaneous nephrostomy, serum creatinine, ure and RRF in DMSA was recorded and compared.

Conditions

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Obstructive Uropathy

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Patients diagnosed with unilateral obstructed kidney with RRF 10% or less underwent application of percutaneous nephrostomy tube on affected side.
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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atrophic kidney

Patients diagnosed with unilateral obstructed kidney with RRF 10% or less underwent application of percutaneous nephrostomy tube on affected side.

Group Type EXPERIMENTAL

Percutaneous nephrostomy

Intervention Type PROCEDURE

Interventions

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Percutaneous nephrostomy

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Unilateral obstructed kidney with RRF 10% or less
* Unilateral obstructed kidney with grade 2 or more hydroureteronephrosis
* Defined etiology for unilateral obstructed kidney
* estimated glomerular filtration rate (GFR) ≥ 30ml/min
* Approving the nephrostomy procedure

Exclusion Criteria

* Unilateral obstructed kidney with RRF above 10%
* Estimated GFR \<30 ml/min
* diagnosis of bilateral obstructed kidneys
* not approving nephrostomy
Minimum Eligible Age

18 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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TC Erciyes University

OTHER

Sponsor Role lead

Responsible Party

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Abdullah Demirtas

Md, Assoc Prof

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Abdullah T Demirtas, Assoc Prof

Role: PRINCIPAL_INVESTIGATOR

Erciyes University Faculty of Medicine

Locations

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Department of Urology, Ercieys University, Faculty Of Medicine,

Kayseri, , Turkey (Türkiye)

Site Status

Countries

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Turkey (Türkiye)

References

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Thorup J, Jokela R, Cortes D, Nielsen OH. The results of 15 years of consistent strategy in treating antenatally suspected pelvi-ureteric junction obstruction. BJU Int. 2003 Jun;91(9):850-2. doi: 10.1046/j.1464-410x.2003.04228.x.

Reference Type BACKGROUND
PMID: 12780846 (View on PubMed)

Gupta DK, Chandrasekharam VV, Srinivas M, Bajpai M. Percutaneous nephrostomy in children with ureteropelvic junction obstruction and poor renal function. Urology. 2001 Mar;57(3):547-50. doi: 10.1016/s0090-4295(00)01046-3.

Reference Type BACKGROUND
PMID: 11248637 (View on PubMed)

Ismail A, Elkholy A, Zaghmout O, Alkadhi A, Elnaggar O, Khairat A, Elhassanat H, Mosleh A, Hamad B, Elzomer J, Elkaabi A. Postnatal management of antenatally diagnosed ureteropelvic junction obstruction. J Pediatr Urol. 2006 Jun;2(3):163-8. doi: 10.1016/j.jpurol.2005.07.005. Epub 2005 Aug 26.

Reference Type BACKGROUND
PMID: 18947602 (View on PubMed)

Morduchowicz G, Winkler J, Zabludowski JR, Boner G. Effects of residual renal function in haemodialysis patients. Int Urol Nephrol. 1994;26(1):125-31. doi: 10.1007/BF02768252.

Reference Type BACKGROUND
PMID: 8026917 (View on PubMed)

Wang AY, Wang M, Woo J, Law MC, Chow KM, Li PK, Lui SF, Sanderson JE. A novel association between residual renal function and left ventricular hypertrophy in peritoneal dialysis patients. Kidney Int. 2002 Aug;62(2):639-47. doi: 10.1046/j.1523-1755.2002.00471.x.

Reference Type BACKGROUND
PMID: 12110029 (View on PubMed)

Bargman JM, Thorpe KE, Churchill DN. Relative contribution of residual renal function and peritoneal clearance to adequacy of dialysis: a reanalysis of the CANUSA study. J Am Soc Nephrol. 2001 Oct;12(10):2158-2162. doi: 10.1681/ASN.V12102158.

Reference Type BACKGROUND
PMID: 11562415 (View on PubMed)

Zhang S, Zhang Q, Ji C, Zhao X, Liu G, Zhang S, Li X, Lian H, Zhang G, Guo H. Improved split renal function after percutaneous nephrostomy in young adults with severe hydronephrosis due to ureteropelvic junction obstruction. J Urol. 2015 Jan;193(1):191-5. doi: 10.1016/j.juro.2014.07.005. Epub 2014 Jul 9.

Reference Type RESULT
PMID: 25014578 (View on PubMed)

Aziz MA, Hossain AZ, Banu T, Karim MS, Islam N, Sultana H, Alam MI, Hanif A, Khan AR. In hydronephrosis less than 10 % kidney function is not an indication for nephrectomy in children. Eur J Pediatr Surg. 2002 Oct;12(5):304-7. doi: 10.1055/s-2002-35956.

Reference Type RESULT
PMID: 12469255 (View on PubMed)

Other Identifiers

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2014/349

Identifier Type: -

Identifier Source: org_study_id

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