The Associativity Analysis Of Nephro-dynamic Imaging And Chronic Obstructive Nephropathy Prognosis

Objective: To evaluate the renal function lesion caused by chronic obstructive nephropathy (principally on serious chronic obstructive nephropathy) and the relationship with renal function recovery after the obstruction removed through nephro-dynamic imaging and to find a comparatively definite quantitative relationship between them for the reference of clinical serious chronic obstruction nephropathy healing (operation).Method: To collect the in hospital obstructive nephropathy cases of the Urinary Surgery department of our institute from Jan 2003 to Dec 2007. For all cases we do urinary system ultrasound, plain abdominal radiograph, urinary routine analysis, renal function, determine separate kidney glomerular filtration rate and renal plasma flow, establish chronic obstructive nephropathy diagnose and classify the results accordingly to three groups as light (GFR above 20ml/min/1.73 m~2), medium (GFR between 10-20 ml/min/1.73 m~2) and serious (GFR below 10 ml/min/1.73 m~2). Among them, the light has 36 patients, while the medium has 44 and the serious has 41. Applied surgery methods include operation, stoma and bracket drainage to remove the obstruction. Recheck the separate kidney glomerular filtration rate and renal plasma flow in three months and compare the result with those of before the obstruction removal by statistics method.Result: After the statistics analyze of the differences of the separate kidney glomerular filtration rates and renal plasma flows before and after the obstruction removed(three month later), the result shows that there is no obvious change on the opposite side kidney function after the operations, nephro-dynamic imaging shows that the lightly damaged group's renal function can roughly recover after the obstruction removed, the diseased kidney's contour gets somewhat minification to pretherapy ; for the medium damaged group part of the renal function can recover partially, the diseased kidney's contour gets obvious minification , the cortex shows some radioactive uptake but lower than the normal kidney; for the serious damaged group there's almost no recovery. The result shows obvious difference in three groups.Conclusion: This experiment shows that to the chronic obstructive nephropathy when there is light or medium damage to the renal function (GFR above 10 ml/min/1.73 m~2) there will be obvious recovery after the operation so for such cases obstructive removal and operation on kidney is recommended, but when the damage is serious (when the GFR is below 10 ml/min/1.73 m~2) there will be no obvious recovery after the operation so for such cases if the opposite side kidney is good we should cut off the serious damaged kidney to prevent repeated infection and other complications.