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Effects on renal outcome of concomitant acute pyelonephritis, acute kidney injury and obstruction duration in obstructive uropathy by urolithiasis: A retrospective cohort study

BMJ Open Nov 13, 2019

Lee EH, et al. - In this retrospective cohort study of 1,607 persons from a urolithiasis-related obstructive uropathy cohort between January 2005 and December 2015, researchers examined the impact of obstruction duration, concomitant acute kidney injury (AKI) or acute pyelonephritis (APN) during the obstruction on the prognosis of renal function. When adjusted for gender, age, hypertension, diabetes mellitus, APN, AKI grades, and obstruction release > 7 days for multivariate analysis, concomitant APN, concomitant AKI and an obstruction span > 7 days were independently related to an eGFR reduction of > 50%. Tree analysis also revealed that the most important factors influencing the renal outcome were AKI grade 3, APN and an obstruction span >7 days. Thus, in individuals with urolithiasis-related obstructive uropathy, concomitant APN was strongly correlated with the decline of renal function following obstruction release. Moreover, renal function was also influenced by the lapsed time to release the obstruction.
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