Risk factors for postobstructive diuresis in pediatric patients with ureteropelvic junction obstruction, following open pyeloplasty in three high complexity institutions
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Date
2018-02-20Authors
Pedraza Bermeo, Adriana MarcelaOrtiz-Zableh, Ana María
Castillo Arteaga, Mariangel
Perez Niño, Jaime
Corporate Author(s)
Pontificia Universidad Javeriana. Facultad de Medicina. Departamento de Cirugía y Especialidades. Grupo de Investigación de Cirugía y Especialidades
Pontificia Universidad Javeriana. Facultad de Medicina. Departamento de Cirugía y Especialidades. Urología
Type
Artículo de investigación
ISSN
1477-5131 / 1873-4898 (Electrónico)
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Abstract
Introduction:
Postobstructive diuresis (POD) is a polyuric state in which large quantities of salt and water are eliminated after solving a urinary tract obstruction. These patients are at increased risk of severe dehydration, electrolytic disturbances, hypovolemic shock, and death. Ureteropelvic junction obstruction (UPJO) is the most common etiology of collecting system dilatation in the fetal kidney, and a significant number of patients require pyeloplasty. There are limited data regarding prognostic risk factors for POD in this scenario.
Objective:
To describe possible clinical risk factors for POD in the pediatric population after open pyeloplasty.
Study design:
This was a retrospective case series study of consecutive patients diagnosed with UPJO at three high complexity centers, managed with open pyeloplasty from 2006 to 2016. Multiple qualitative and quantitative variables possibly associated with POD were included according to the literature review. They were statistically analyzed with STATA 14 software.
Results:
A total of 88 patients with UPJO following open pyeloplasty were analyzed. Twenty-seven patients (30%) had POD. A tendency to present POD in younger patients was found, with a mean age of 20.2 months vs. 72.3 months. There was also an increased risk of POD in patients with previous diagnosis of tubular acidosis.
Conclusions:
There are no data about prognostic clinical risk
factors for POD after open pyeloplasty in the pediatric population. Our study corresponds to one of
the larger series reported so far. It suggests that
younger patients and patients with a previous diagnosis of tubular acidosis could be at greater risk of POD. Consequently, prospective studies are required for validation of our results, and possible impact on patient follow-up.
Temporary coverage
2006-2016Link to the resource
https://login.ezproxy.javeriana.edu.co/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=edselc&AN=edselc.2-52.0-85042649745&lang=es&site=eds-liveSource
Journal of Pediatric Urology; Volumen 14 Número 3 , Páginas 260.e1 - 260.e4 (2018)
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