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You have accessJournal of UrologyReconstruction: Ureteral Reconstruction (Including Pyeloplasty) and Bladder Reconstruction (Including Trauma-Related Fistula) I (MP48)1 May 2024MP48-03 NATURAL HISTORY OF RENAL DYSFUNCTION FOR NON-MALIGNANT URETERAL OBSTRUCTION: A COMPARATIVE ANALYSIS BETWEEN URETERAL RECONSTRUCTION AND STENT/NEPHROSTOMY TUBE DRAINAGE Bridget L. Findlay, Anthony Fadel, Dan S. Ubl, Elizabeth Habermann, Katherine T. Anderson, Kevin M. Wymer, and Boyd R. Viers Bridget L. FindlayBridget L. Findlay , Anthony FadelAnthony Fadel , Dan S. UblDan S. Ubl , Elizabeth HabermannElizabeth Habermann , Katherine T. AndersonKatherine T. Anderson , Kevin M. WymerKevin M. Wymer , and Boyd R. ViersBoyd R. Viers View All Author Informationhttps://doi.org/10.1097/01.JU.0001009512.15743.d7.03AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Natural history of renal dysfunction in patients presenting with ureteral obstruction is unknown. There is a lack of evidence-based criteria for determining intervention type intending to mitigate disease progression in this population. We aim to describe disease progression and associated risk factors in patients with ureteral non-malignant obstruction managed with either ureteral reconstruction (UR) or ureteral stent/nephrostomy tube (US/NT). METHODS: Our institutional database was queried for patients with ureteral obstruction from 2006 to 2020. Patients were classified into UR or US/NT group based on CPT codes. The primary outcome was chronic kidney disease (CKD) stage progression over time from baseline as defined by estimated glomerular filtration rate (eGFR). Univariable analyses were performed to compare outcomes, patient characteristics, and median eGFR over time by intervention type. Cumulative incidence function and adjusted analyses were performed to observe the proportion of cases experiencing disease progression over time and adjusting for clinical factors, respectively. RESULTS: A total of 1319 patients were included for analysis, 446 (34%) underwent UR and 873 US/NT (66%). Compared to US/NT, cases undergoing UR were younger, more often female, and less comorbid with lower prevalence of diabetes, hypertension, or cardiovascular disease (all p<0.05). Baseline CKD stage was lower for UR cases (Median stage 2 vs stage 3, p<0.05), while cumulative overall incidence of disease progression was not statistically significantly lower among UR cases at 10 years (p=0.06). Stratified on baseline CKD stage, cumulative incidence of CKD stage progression was higher at 10 years among US/NT for stages 1 and 2, both p<0.05 (Figure 1). On multivariable analysis, US/NT patients with a baseline CKD stage of 1 had a higher hazard of CKD stage progression (HR: 2.67; CI: 1.37-5.19) when compared to their UR counterparts. CONCLUSIONS: In patients with non-malignant ureteral obstruction, CKD stage progression varies by intervention type, with greater risk associated with US/NT compared to UR, especially for those with lower stages of baseline CKD. These findings should be considered when engaging in counseling for management of ureteral obstruction. Download PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e772 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Bridget L. Findlay More articles by this author Anthony Fadel More articles by this author Dan S. Ubl More articles by this author Elizabeth Habermann More articles by this author Katherine T. Anderson More articles by this author Kevin M. Wymer More articles by this author Boyd R. Viers More articles by this author Expand All Advertisement PDF downloadLoading ...
Findlay et al. (Mon,) studied this question.