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单侧输尿管支架置入患者肾实质宽度的变化:一项双中心回顾性研究。

Change of Renal Parenchymal Width in Patients with Unilateral Ureteral Stent: A Bicenter Retrospective Study.

作者信息

Kim Hee Youn, Lee Seung-Ju, Choi Jin Bong, Yoo Je Mo, Lee Joon Ho, Lee Dong Sup

机构信息

Department of Urology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Republic of Korea.

Department of Urology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.

出版信息

Biomed Res Int. 2017;2017:1653184. doi: 10.1155/2017/1653184. Epub 2017 Jun 1.

Abstract

PURPOSE

To determine whether kidney sizes were changed after ureteral stents were instilled, and if so, what parameters were significant.

METHODS

Parenchymal width (PW) of 98 patients with unilateral ureteral stents was measured from the coronal view of CT scans for both stented and unstented contralateral kidney. The mean PW and % change of mean PW were calculated before stenting and at the time of last stent change. Estimated glomerular filtrate rate (eGFR) was recorded as well.

RESULTS

The mean duration of ureteral stent indwelled was 15.6 ± 10.2 (mean ± SD) months. The change of mean PW of stented kidneys and unstented contralateral kidneys was -16.9 ± 16.4 (mean ± SD)% and 3.6 ± 10.7%, respectively. eGFR before and at the time of the last stent change did not show significant difference ( = 0.294). Duration of ureteral stent indwelled was found to be inversely related to the % change of mean PW (Spearman's correlation coefficient = -0.291, < 0.001).

CONCLUSIONS

For unilateral ureteral obstruction, kidney size was decreased over time in spite of indwelling ureteral stent. This finding can be overlooked by clinicians due to compensatory growth of contralateral kidney and resultant normal eGFR.

摘要

目的

确定输尿管支架置入后肾脏大小是否发生变化,若有变化,哪些参数具有显著性。

方法

从CT扫描的冠状面测量98例单侧输尿管支架置入患者的支架侧和对侧未置入支架肾脏的实质宽度(PW)。计算支架置入前和最后一次更换支架时的平均PW及其变化百分比。同时记录估计肾小球滤过率(eGFR)。

结果

输尿管支架置入的平均持续时间为15.6±10.2(均值±标准差)个月。支架侧肾脏和对侧未置入支架肾脏的平均PW变化分别为-16.9±16.4(均值±标准差)%和3.6±10.7%。最后一次更换支架时的eGFR与之前相比无显著差异(P=0.294)。发现输尿管支架置入持续时间与平均PW变化百分比呈负相关(Spearman相关系数=-0.291,P<0.001)。

结论

对于单侧输尿管梗阻,尽管置入了输尿管支架,但肾脏大小会随时间减小。由于对侧肾脏的代偿性生长以及由此导致的eGFR正常,这一发现可能会被临床医生忽视。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e6e9/5471575/2d09eee62a86/BMRI2017-1653184.001.jpg

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