Demirtaş A, Golbasi A, Guleser AS, Sönmez G, Demirtaş T, GÜR A, Tombul ŞT. Demirtas Two-Step Treatment Model in Hypofunctional-Obstructed Kidneys: An Extended Series and Long-Term Prospective Results.
Cureus 2022;
14:e26128. [PMID:
35875311 PMCID:
PMC9298605 DOI:
10.7759/cureus.26128]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/20/2022] [Indexed: 11/30/2022] Open
Abstract
Aim: This study aimed to present the short- and long-term results of Demirtas two-step treatment model in patients with obstructed-hydronephrotic kidneys functioning below 10%, and before deciding on nephrectomy, to evaluate whether this method can contribute to the accurate assessment.
Material and methods: This prospective study included patients with unilateral renal obstruction and renal parenchymal loss assessed by computed tomography and whose renal function was found to be below 10% in Tc-99m-dimercaptosuccinic acid. In the first step, percutaneous nephrostomy (PCN) was performed. Two weeks later, the second step was performed, in which patients were offered nephrectomy (if renal function was <10%) or etiology-based treatment (if renal function was ≥10%).
Results: Thirty-eight patients were included in the study, comprising 20 (52.6%) men and 18 (47.4%) women with a mean age of 51.3±16.8 years. Mean baseline renal function was 6.0%, which increased to 10.8% two weeks after PCN (p=0.001). Renal function increased to above 10% in 20 (52.6%) out of 38 patients. Of these, 17 patients underwent etiology-based treatment and baseline, two-week, and 12-month renal function levels were 7.0%, 17.5%, and 18.8%, respectively (p<0.001).
Conclusion: Demirtas two-step treatment model introduced in the present study can be recommended as a standard treatment modality in unilaterally obstructed kidneys functioning below 10% ability.
Collapse