value of intrapelvic pressure Renal Pressure as a Prognostic Parameter For Recovery Potential of an obstructed kidney

Abstract

The ability to predict preoperati vely whether a hydronephrotic kidney will regain function after releif of obstruction helps to decide whether to correct the obstruction or to perform nephrectomy. Prediction of the potential for recovery of renal function in obstructive uropathy is difficult and unreliable. The ability of the complete obstructed human kidney to recover useful function after relief of obstruction is related to patient’s age, duration of obstruction and presence or absence of infection among many other factors. Twenty-three patients with unilateral radiologically non-visualized obstructed kidneys (as proved by I.V.U, ultrasonography) with normal contralateral kidneys were divided into three groups according to the renal intrapelvic pressure:- Group I included 6 patients with renal intrapelvic pressure less than 20 cm H20, group II included 1 1 patients with intrapelvic pressure 20-40 cm H20, and group III included 6 patients with intrapelvic pressure more than 40 cm H20. The obstruction was circumvented in all patients by PCN fixation. "mTc-DMSA studies were performed on presentation to all patients and two months after PCN fixation. Specific gravity and daily urine output from the involved kidney was measured for two weeks, then measured weekly for 6 weeks.