尿管閉塞による急性腎不全61例の検討

Abstract

The clinical course of 61 patients with post-renal acute renal failure caused by ureteral obstruction seen between January, 1976 and December, 1985, was studied retrospectively. Twenty of the patients were men between 55 and 85 years old, and 41 were women between 35 and 82 years old. In 50 of the 61 patients, uremia was caused by ureteral obstruction secondary to malignant tumors, and in 11, it was secondary to benign diseases. We divided the patients into two groups, those with primary malignant tumors and those with benign diseases. The location of the primary tumors in the malignant group was the genital system in 28 patients, upper gastrointestinal tract in 7, colorectum in 12, the urinary system in 2, and one was unclear. The benign group included 4 with urolithiasis, 3 with pelviureteral junction stenosis, 3 with post-operative ureteral stricture, and 1 with bilateral ureteral ligation due to operation error. Urinary diversion or reconstruction was performed on 56 of the 61 patients; bilateral nephrostomy in 6, unilateral nephrostomy in 16, bilateral ureterocutaneostomy in 8, unilateral ureterocutaneostomy in 11, unilateral nephrostomy with contralateral ureterocutaneostomy in 2, ureterolithotomy in 2, pyeloplasty in 2, ureterovesiconeostomy in 1, and insertion of a ureteral stent in 8. Of the remaining 4 patients 3 were treated by hemodialysis, and the other patient refused treatment. There was no significant difference in recovery of renal function between those patients undergoing only unilateral diversion and those undergoing bilateral diversion.(ABSTRACT TRUNCATED AT 250 WORDS)