Skip to main content
Log in

Transient renal impairment in the absence of pre-existing chronic kidney disease in patients with unilateral ureteric stone impaction

  • Original Paper
  • Published:
Urolithiasis Aims and scope Submit manuscript

Abstract

This study aims to describe the rate and characteristics of transient renal impairment in unilateral ureteric stone patients without chronic kidney disease (CKD) and to identify factors that may have influenced renal function of these patients. Unilateral ureteric stone patients who visited our hospital’s emergency department from December, 2009 to December, 2015 were divided into two groups based on estimated glomerular filtration rate (eGFR): group I (patients with eGFR ≥ 60 ml/min/1.73 m2) and group II (eGFR < 60 ml/min/1.73 m2). A univariate comparison between groups I and II was performed. Multivariable logistic regression analysis was performed to determine factors that influenced renal function. There were 107 patients in group II, which constituted 5.6 % of the total patients. In the multivariable logistic regression analysis, age (p < 0.001, odds ratio [OR] = 1.069, confidence interval [CI] = 1.049–1.089), hypertension (p < 0.001, OR = 2.302, CI = 1.467–3.611), stone size (p = 0.001, OR = 1.141, CI = 1.057–1.231), white blood cell count (p = 0.001, OR = 1.132, CI = 1.055–1.215) and hematuria (p < 0.001, OR = 0.383, CI = 0.231–0.636) were found to be independent factors for renal impairment. Based on the results of this study, the rate of renal impairment was 6 % of the unilateral ureteric stone patients without pre-existing CKD. Age and hypertension were found to be independent factors for renal impairment; NSAIDs should be used cautiously or other agents for pain relief such as opioids should be considered in old aged patients with hypertension.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Brown J (2006) Diagnostic and treatment patterns for renal colic in US emergency departments. Int Urol Nephrol 38(1):87–92. doi:10.1007/s11255-005-3622-6

    Article  CAS  PubMed  Google Scholar 

  2. Turk C, Petrik A, Sarica K, Seitz C, Skolarikos A, Straub M, Knoll T (2015) EAU guidelines on diagnosis and conservative management of urolithiasis. Eur Urol. doi:10.1016/j.eururo.2015.07.040

    Google Scholar 

  3. Stillman MT, Schlesinger PA (1990) Nonsteroidal anti-inflammatory drug nephrotoxicity. Should we be concerned? Arch Intern Med 150(2):268–270

    Article  CAS  PubMed  Google Scholar 

  4. Whelton A (1999) Nephrotoxicity of nonsteroidal anti-inflammatory drugs: physiologic foundations and clinical implications. Am J Med 106(5B):13S–24S

    Article  CAS  PubMed  Google Scholar 

  5. Brater DC (1999) Effects of nonsteroidal anti-inflammatory drugs on renal function: focus on cyclooxygenase-2-selective inhibition. Am J Med 107(6A):65S–70S (discussion 70S–71S)

    Article  CAS  PubMed  Google Scholar 

  6. Zabihi N, Teichman JM (2001) Dealing with the pain of renal colic. Lancet 358(9280):437–438. doi:10.1016/S0140-6736(01)05668-9

    Article  CAS  PubMed  Google Scholar 

  7. Beetz R, Bokenkamp A, Brandis M, Hoyer P, John U, Kemper MJ, Kirschstein M, Kuwertz-Broking E, Misselwitz J, Muller-Wiefel DE, Rascher W (2001) Diagnosis of congenital dilatation of the urinary tract. Consensus Group of the Pediatric Nephrology Working Society in cooperation with the Pediatric Urology Working Group of the German Society of Urology and with the Pediatric Urology Working Society in the Germany Society of Pediatric Surgery. Urologe A 40(6):495–507 (quiz 508–499)

    Article  CAS  PubMed  Google Scholar 

  8. Levey AS, Coresh J, Greene T, Stevens LA, Zhang YL, Hendriksen S, Kusek JW, Van Lente F, Chronic Kidney Disease Epidemiology C (2006) Using standardized serum creatinine values in the modification of diet in renal disease study equation for estimating glomerular filtration rate. Ann Intern Med 145(4):247–254

    Article  CAS  PubMed  Google Scholar 

  9. Castle WN, McDougal WS (1984) Contralateral renal hyperplasia and increased renal function after relief of chronic unilateral ureteral obstruction. J Urol 132(5):1016–1020

    CAS  PubMed  Google Scholar 

  10. Pearle MS, Pierce HL, Miller GL, Summa JA, Mutz JM, Petty BA, Roehrborn CG, Kryger JV, Nakada SY (1998) Optimal method of urgent decompression of the collecting system for obstruction and infection due to ureteral calculi. J Urol 160(4):1260–1264

    Article  CAS  PubMed  Google Scholar 

  11. Shen W, Li W, Pan J, Yan J, Xiong E, Li L, Zhou Z, Song B, Lu G (2011) Specific management of acute renal failure caused by an upper ureteral stone in a solitary pelvic kidney. Urol Res 39(1):77–79. doi:10.1007/s00240-010-0268-3

    Article  CAS  PubMed  Google Scholar 

  12. Tan FQ, Shen BH, Xie LP, Meng HZ, Fang DB, Wang CJ (2013) Management experience of acute renal failure induced by unilateral ureteral calculi obstruction. Zhonghua Yi Xue Za Zhi 93(20):1580–1582

    PubMed  Google Scholar 

  13. Al-Ani A, Al-Jalham K, Ibrahim T, Majzoub A, Al-Rayashi M, Hayati A, Mubarak W, Al-Rayahi J, Khairy AT (2015) Factors determining renal impairment in unilateral ureteral colic secondary to calcular disease: a prospective study. Int Urol Nephrol 47(7):1085–1090. doi:10.1007/s11255-015-0986-0

    Article  CAS  PubMed  Google Scholar 

  14. Levey AS, de Jong PE, Coresh J, El Nahas M, Astor BC, Matsushita K, Gansevoort RT, Kasiske BL, Eckardt KU (2011) The definition, classification, and prognosis of chronic kidney disease: a KDIGO controversies conference report. Kidney Int 80(1):17–28. doi:10.1038/ki.2010.483

    Article  PubMed  Google Scholar 

  15. Levey AS, Coresh J (2012) Chronic kidney disease. Lancet 379(9811):165–180. doi:10.1016/S0140-6736(11)60178-5

    Article  PubMed  Google Scholar 

  16. Rowe JW, Andres R, Tobin JD, Norris AH, Shock NW (1976) The effect of age on creatinine clearance in men: a cross-sectional and longitudinal study. J Gerontol 31(2):155–163

    Article  CAS  PubMed  Google Scholar 

  17. Hollenberg NK, Adams DF, Solomon HS, Rashid A, Abrams HL, Merrill JP (1974) Senescence and the renal vasculature in normal man. Circ Res 34(3):309–316

    Article  CAS  PubMed  Google Scholar 

  18. Bolton WK, Benton FR, Maclay JG, Sturgill BC (1976) Spontaneous glomerular sclerosis in aging Sprague-Dawley rats. I. Lesions associated with mesangial IgM deposits. Am J Pathol 85(2):277–302

    CAS  PubMed  PubMed Central  Google Scholar 

  19. Castellani S, Ungar A, Cantini C, La Cava G, Di Serio C, Altobelli A, Vallotti B, Pellegri M, Brocchi A, Camaiti A, Coppo M, Meldolesi U, Messeri G, Masotti G (1998) Excessive vasoconstriction after stress by the aging kidney: inadequate prostaglandin modulation of increased endothelin activity. J Lab Clin Med 132(3):186–194

    Article  CAS  PubMed  Google Scholar 

  20. Tank JE, Vora JP, Houghton DC, Anderson S (1994) Altered renal vascular responses in the aging rat kidney. Am J Physiol 266(6 Pt 2):F942–F948

    CAS  PubMed  Google Scholar 

  21. Nyengaard JR, Bendtsen TF (1992) Glomerular number and size in relation to age, kidney weight, and body surface in normal man. Anat Rec 232(2):194–201. doi:10.1002/ar.1092320205

    Article  CAS  PubMed  Google Scholar 

  22. Kaplan C, Pasternack B, Shah H, Gallo G (1975) Age-related incidence of sclerotic glomeruli in human kidneys. Am J Pathol 80(2):227–234

    CAS  PubMed  PubMed Central  Google Scholar 

  23. Hill GS, Heudes D, Bariety J (2003) Morphometric study of arterioles and glomeruli in the aging kidney suggests focal loss of autoregulation. Kidney Int 63(3):1027–1036. doi:10.1046/j.1523-1755.2003.00831.x

    Article  PubMed  Google Scholar 

  24. Weinstein JR, Anderson S (2010) The aging kidney: physiological changes. Adv Chronic Kidney Dis 17(4):302–307. doi:10.1053/j.ackd.2010.05.002

    Article  PubMed  PubMed Central  Google Scholar 

  25. Gargiulo R, Suhail F, Lerma EV (2015) Hypertension and chronic kidney disease. Dis Mon 61(9):387–395. doi:10.1016/j.disamonth.2015.07.003

    Article  PubMed  Google Scholar 

  26. Keane WF, Eknoyan G (1999) Proteinuria, albuminuria, risk, assessment, detection, elimination (PARADE): a position paper of the National Kidney Foundation. Am J Kidney Dis 33(5):1004–1010

    Article  CAS  PubMed  Google Scholar 

  27. Yoshioka T, Rennke HG, Salant DJ, Deen WM, Ichikawa I (1987) Role of abnormally high transmural pressure in the permselectivity defect of glomerular capillary wall: a study in early passive Heymann nephritis. Circ Res 61(4):531–538

    Article  CAS  PubMed  Google Scholar 

  28. Finlay S, Bray B, Lewington AJ, Hunter-Rowe CT, Banerjee A, Atkinson JM, Jones MC (2013) Identification of risk factors associated with acute kidney injury in patients admitted to acute medical units. Clin Med (Lond) 13(3):233–238. doi:10.7861/clinmedicine.13-3-233

    Article  CAS  Google Scholar 

  29. Leblanc M, Kellum JA, Gibney RT, Lieberthal W, Tumlin J, Mehta R (2005) Risk factors for acute renal failure: inherent and modifiable risks. Curr Opin Crit Care 11(6):533–536

    Article  PubMed  Google Scholar 

  30. Sfoungaristos S, Kavouras A, Katafigiotis I, Perimenis P (2012) Role of white blood cell and neutrophil counts in predicting spontaneous stone passage in patients with renal colic. BJU Int 110(8 Pt B):E339–E345. doi:10.1111/j.1464-410X.2012.11014.x

    Article  PubMed  Google Scholar 

  31. Rosenzweig B, Pinthus JH, Kleinmann N, Joffe E, Erlich T, Fridman E, Winkler H, Mor Y, Ramon J, Dotan ZA (2015) The relative contribution of urine extravasation to elevate plasma creatinine levels in acute unilateral ureteral obstruction. Can Urol Assoc J 9(7–8):E428–E433. doi:10.5489/cuaj.2804

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Seung-Ju Lee.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants performed by any of the authors.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kim, H.Y., Choe, HS., Lee, D.S. et al. Transient renal impairment in the absence of pre-existing chronic kidney disease in patients with unilateral ureteric stone impaction. Urolithiasis 45, 249–254 (2017). https://doi.org/10.1007/s00240-016-0904-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00240-016-0904-7

Keywords

Navigation