Obstructive uropathy

This is a study of 1607 patients with a urolithiasis-related obstructive uropathy between January 2005 and December 2015. Clinical outcomes were evaluated with respect to obstruction duration, acute kidney injury (AKI), and acute pyelonephritis (APN) accompanied by obstructive uropathy. The primary objective of this study was to evaluate whether the duration of urinary tract obstruction affects the renal outcome. The secondary objective was to evaluate whether the AKI, APN or both events affect the renal outcome. Renal outcomes were evaluated with an eGFR decrease ≥ 30% and/or end-stage renal disease (ESRD), and an eGFR decrease ≥ 50% and/or ESRD. Obstruction duration is an independent risk factor for poor renal outcome with concomitant APN and AKI in urolithiasis related obstructive uropathy. Early obstruction release may contribute to the improvement of prognosis by reducing the incidence of infection or acute renal failure.本研究纳入2005年1月至2015年12月期间的1607例尿路结石相关性梗阻性肾病（urolithiasis-related obstructive uropathy）患者。本研究围绕梗阻时长、合并梗阻性肾病的急性肾损伤（AKI）及急性肾盂肾炎（APN）对临床结局的影响展开评估。本研究的首要目标为明确尿路梗阻时长是否会对肾脏结局产生影响，次要目标为评估AKI、APN或二者同时发生是否会影响肾脏结局。肾脏结局的评估指标包括：估算肾小球滤过率（eGFR）下降≥30%且/或终末期肾病（ESRD），以及eGFR下降≥50%且/或ESRD。在尿路结石相关性梗阻性肾病患者中，当同时合并APN与AKI时，梗阻时长是不良肾脏结局的独立危险因素。早期解除梗阻可通过降低感染或急性肾衰竭的发生率，有助于改善患者预后。