CLINICAL AND PARACLINICAL CHARACTERISTICS OF PATIENTS WITH NON-FUNCTIONING KIDNEYS CAUSED BY SELECTED BENIGN DISEASES UNDERGOING SURGICAL TREATMENT AT THANH HOA PROVINCIAL GENERAL HOSPITAL
Main Article Content
Abstract
Objective: To describe the clinical and paraclinical characteristics of patients with non-functioning kidneys caused by selected benign diseases who underwent surgical treatment.
Subjects and methods: A descriptive study with retrospective and prospective data collection was conducted on 73 patients diagnosed with non-functioning kidneys caused by benign obstructive diseases and surgically treated at Thanh Hoa provincial General Hospital from January 2022 to June 2025.
Results: The mean age was 61.1 ± 13.9 years, and 63% of patients were older than 60 years. Chronic flank pain was the most common reason for admission (82.2%), and renal angle tenderness was found in 90.4%. Leukocytosis was present in 38.4%; positive hematuria and pyuria were observed in approximately 65.8% and 53.4%, respectively. On computed tomography, grade III-IV hydronephrosis accounted for 83.6%; renal stones 58.9%; ureteral stones 64.4%; and ureteral dilatation 71.2%. Forty-three patients (58.9%) had split renal function < 10% on radionuclide renography, while the remaining 30 cases were diagnosed on the basis of combined clinical, imaging, and post-drainage findings. All postoperative histopathology specimens were benign.
Conclusions: Surgically treated patients with benign disease-related non-functioning kidneys were predominantly older adults and commonly presented with chronic flank pain (82.2%) and features of urinary obstruction/infection (83,6% grade III-IV hydronephrosis on CT scan). Computed tomography and radionuclide renography played important roles in confirming severe structural and functional renal damage and supporting surgical indication.
Article Details
Keywords
Non-functioning kidney, benign disease, obstructive uropathy, nephrectomy, clinical and paraclinical features.
References
[2] Angerri O et al. Simple laparoscopic nephrectomy in stone disease: not always simple. J Endourol, 2016, 30 (10): 1095-1098. doi: 10.1089/end.2016.0281. Epub 2016 Sep 14.
[3] Taylor A.T, Brandon D.C, de Palma D et al. SNMMI procedure standard/EANM practice guideline for diuretic renal scintigraphy in adults with suspected upper urinary tract obstruction 1.0. Semin Nucl Med, 2018, 48 (4): 377-390. doi: 10.1053/j.semnuclmed.2018.02.010
[4] Onen A. Grading of hydronephrosis: an ongoing challenge. Front Pediatr, 2020, 8: 458. doi: 10.3389/fped.2020.00458
[5] Asai S, Fukumoto T, Watanabe R et al. New classification of hydronephrosis on 18F-FDG-PET/CT predicts post-operative renal function and muscle-invasive disease in patients with upper urinary tract urothelial carcinoma. Jpn J Clin Oncol, 2018, 48 (11): 1022-1027. doi: 10.1093/jjco/hyy135
[6] Gupta N.P, Hemal A.K, Mishra S, Dogra P.N, Kumar R. Outcome of retroperitoneoscopic nephrectomy for benign nonfunctioning kidney: a single-center experience. Journal of Endourology, 2008, 22 (4): 693-698. doi: 10.1089/end.2007.0267
[7] Tepeler A, Akman T, Tok A et al. Retroperitoneoscopic nephrectomy for non-functioning kidneys related to renal stone disease. Urol Res, 2012, 40 (5): 559-565. doi: 10.1007/s00240-012-0466-2
[8] Peña P.A, Torres-Castellanos L, Patiño G, Prada S, Villarraga L.G, Fernández N. Minimally invasive nephrectomy for inflammatory renal disease. Asian J Urol, 2020, 7 (4): 345-350. doi: 10.1016/j.ajur.2019.09.002
[9] Klaipetch A, Namwongprom S, Ekmahachai M, Lojanapiwat B. Excretory urography and renal scintigraphy for chronic obstructed kidney: does nonopacity mean nonsalvageability? Singapore Med J, 2013, 54 (5): 267-270. doi: 10.11622/smedj.2013106.