CALCULUS RENAL FAILURE

A STUDY TO PROFILE THE CALCULUS RENAL FAILURE AND ITS MANAGEMENT STRATEGY

Abstract

Background: Urolithiasis is a common urological disease in Pakistan. Calculus
renal failure is a urological emergency that required immediate intervention to prevent further
deterioration of renal function. Objectives: The purpose of this study is to present clinical profile
of calculus renal failure patient and to report our experience of management of such patients.
Study Design: Descriptive Cross sectional study. Setting and Period: Department of urology
Services Hospital from July 2015 to December 2016 were included. Materials and Methods:
Patients of all ages of either sex who presented with calculus renal failure. The patients with
obstructive uropathy due to causes other than stone disease were excluded. Demographic
information along with detailed history recorded. Baseline investigations included Complete
blood counts, serum creatinine, serum electrolytes and ultrasound for KUB. For stone position
Xray KUB in every case & CT in selected cases performed. Functional status of individual kidney
was assessed by renal scan with differential GFR. After initial emergency treatment, all patients
were subjected to definite treatment depending upon stone location and functional status of
kidney. Results: A total of 68 patients were recruited for this study. The mean age of the patients
was 48.8 + 14.13 with range 23-90. 52(76.5%) of the patients were male and 16(23.5%)
were females. Most common presentation was lumber pain 46 (67.6%) followed by anorexia 42
(61.8%). The average presence of the symptoms was 17.70 days. At initial management of the
condition contained, 16(23.5%) of the patients managed by peritoneal dialysis /Hemodialysis,
10(14.7%) by unilateral PCN, 16(23.5%) by Bilateral PCN, unilateral JJ stenting done in 8(11.8%)
while bilateral JJ stenting in 07 (10.9%), 6(8.8%). 10(14.7%) patient were managed with URS/
Lithoclast therapy without any prior diversion. Renal function in 08 patients (11.8%) did not
improved after initial management and they remained on maintenance dialysis. Conclusion: In
time diagnosis and early proper treatment improves the outcome.