Hydronephrosis
Conditions
Brief summary
Hydronephrosis describes a condition of urine-filled dilation of the collecting system. Normally, urine flows through the urinary tract with minimal or low pressure. If the build-up of excess fluid in the urinary collecting system continues, there will be an increase in pressure and atrophy of renal cortex. If hydronephrosis is left untreated for a long time, renal damage with permanent loss of function occurs
Interventions
PROCEDUREpercutaneous nephrostomy
The percutaneous nephrostomy will be done under sonographic or fluoroscopic guidance. Establishment of intravenous access and antibiotics will be performed half an hour prior to procedure particularly in patients presenting with urinary tract infection. The procedure will be done under local anesthesia but general anesthesia may be used for uncooperative patients. percutaneous nephrostomy will be performed in the prone position, however, in case of relative contraindication to prone position
Sponsors
Assiut University
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Healthy volunteers
No
Inclusion criteria
* 1\) Patients for whom a percutaneous nephrostomy is indicated provided that the hydronephrosis is advanced ( parenchymal thickness not more than 5 mm ) 2) Patients for whom a nephrectomy is planned for a seemingly poorly functioning kidney along with either
Exclusion criteria
1. Target kidney is the only functioning or better functioning kidney or otherwise substantially contributing to the total renal function, so nephrectomy is not likely. 2. Emergency cases where the general condition of the patient cannot withstand the logistics of undergoing a radioisotope study eg 3. Malignancy in the target kidney 4. Patients unlikely to undergo a nephrectomy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| The rate of increase in glomerular filtration rate after intervention | 3 weeks | the radioisotope measurement of glomerular filtration rate will be done before and after insertion of percutaneous nephrostomy tube |
Outcome results
None listed