Analysis of treatment for urosepsis caused by ureteral calculi in solitary kidney_West China Medical Journal

Authors：

WANG Yu ,  LI Kang , ZHU Shuxia

Department of Urology, Chengdu 363 Hospital Affiliated to Southwest Medical University, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

LI Kang, Email: 176154665@qq.com

Keywords：

Solitary kidney; Ureteral calculi; Urosepsis

DOI：

10.7507/1002-0179.202004254

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Objective To investigate the diagnosis and treatment strategy of urosepsis caused by ureteral calculi in solitary kidney. Methods The clinical data of patients with urosepsis caused by ureteral calculi in solitary kidney in the Department of Urology of Chengdu 363 Hospital Affiliated to Southwest Medical University from March 2015 to March 2020 were analyzed retrospectively. Results A total of 23 patients were included. One patient received ureteroscopic holmium laser lithotripsy, after which urosepsis and renal function deteriorated, then got better after anti-infection and hemodialysis treatment in intensive care unit; 17 patients received implantation of ureteral stent by cystoscopy, and 5 patients received percutaneous nephrostomy by ultrasound guiding, the 22 patients received ureteroscopic lithotripsy or flexible ureteroscopic lithotripsy electively. One patients had subcapsular renal hematoma postoperatively and worse renal insufficiency, the rest 22 patients had improved renal function. All patients were cured clinically. Conclusions For solitary kidney patients who have urosepsis caused by ureteral calculi, emergency treatment is necessary. The relief of urinary obstruction must be based on effective anti-infection. Choosing cystoscopic ureteral stent implantation or percutaneous nephrostomy depends on patients’ individualization. Ureterscopic lithotripsy simultaneously is not recommended. Ureteral intubation before cystoscopic ureteral stent implantation is important, which can increase the success rate of ureteral stent implantation.

Citation： WANG Yu, LI Kang, ZHU Shuxia. Analysis of treatment for urosepsis caused by ureteral calculi in solitary kidney. West China Medical Journal, 2021, 36(8): 1072-1076. doi: 10.7507/1002-0179.202004254 Copy

1.	王媛媛, 謝院生. 先天性單腎缺失的研究現狀. 中國中西醫結合腎病雜志, 2017, 18(4): 357-361.
2.	Radhakrishna V, Govindarajan KK, Sambandan K, et al. Solitary functioning kidney in children: clinical implications. J Bras Nefrol, 2018, 40(3): 261-265.
3.	Verma S, Yadav SS, Tomar V, et al. Deterioration in the renal function and risk of microalbuminuria after radical, simple and donor nephrectomy: a long-term outcome. Urol Ann, 2016, 8(2): 184-188.
4.	周先明, 疏仁義, 郭榮利, 等. 孤立腎輸尿管結石急性梗阻伴感染的診治策略. 蚌埠醫學院學報, 2016, 41(6): 757-759.
5.	Mercimet MN, Ender O. Effect of urinary stone disease and its treatment on renal function. World J Nephrol, 2015, 4(2): 271-276.
6.	Dreger NM, Degener S, Ahmad-Nejad P, et al. Urosepsis-etiology, diagnosis, and treatment. Dtsch Arztebl Int, 2015, 112(49): 837-847.
7.	黃仁勝, 陳海華, 龍振河, 等. 孤立腎腎結石微創治療的現狀及進展. 醫學綜述, 2017, 23(13): 2567-2571.
8.	趙紀宇, 劉佳, 谷現恩. 孤立腎合并結石的臨床特點及其微創治療進展. 現代泌尿外科雜志, 2016, 21(6): 483-486.
9.	Shokeir AA, Shoma AM, Abubieh EA, et al. Recoverability of renal function after relief of acute complete ureteral obstruction: clinical prospective study of the role of renal resistive index. Urology, 2002, 59(4): 506-510.
10.	張凱忠, 吳愛明, 潘克, 等. 急性上尿路梗阻性無尿的處理. 臨床泌尿外科雜志, 2005, 20(4): 240-241.
11.	Singer M, Deutschman CS, Seymour CW, et al. The third international consensus definitions for sepsis and septic shock (sepsis-3). JAMA, 2016, 315(8): 801-810.
12.	Rhodes A, Evans LE, Alhazzani W, et al. Surviving sepsis campaign: international guidelines for management of sepsis and septic shock: 2016. Crit Care Med, 2017, 45(3): 486-552.
13.	譚樂明, 楊成, 楊旭凱, 等. 尿源性膿毒血癥嚴重程度的相關因素分析. 南方醫科大學學報, 2019, 39(1): 93-99.
14.	孟祥軍, 李遜, 曾國華, 等. 孤立腎上尿路結石的微創治療. 現代泌尿外科雜志, 2006, 11(2): 89-91.
15.	Kuroda S, Fujikawa A, Tabei T, et al. Retrograde intrarenal surgery for urinary stone disease in patients with solitary kidney: a retrospective analysis of the efficacy and safety. Int J Urol, 2016, 23(1): 69-73.
16.	伍宏亮. 輸尿管鏡鈥激光碎石術后尿源性膿毒血癥的危險因素分析. 中華全科醫學, 2016, 14(12): 2031-2033.
17.	Kao MH, Wang CC. Risk factors for developing a perirenal hematoma after flexible ureteroscopic lithotripsy. Urol Sci, 2016, 27(3): 166-170.
18.	呂佳, 章越龍, 紀阿林, 等. 輸尿管軟鏡碎石術后腎包膜下血腫的危險因素分析. 重慶醫科大學學報, 2018, 43(4): 532-534.
19.	余偉民, 曹智修, 姚小兵, 等. 壓力灌注對不同程度積水腎損傷的評價. 武漢大學學報(醫學版), 2014, 35(6): 839-842.

1. 王媛媛, 謝院生. 先天性單腎缺失的研究現狀. 中國中西醫結合腎病雜志, 2017, 18(4): 357-361.
2. Radhakrishna V, Govindarajan KK, Sambandan K, et al. Solitary functioning kidney in children: clinical implications. J Bras Nefrol, 2018, 40(3): 261-265.
3. Verma S, Yadav SS, Tomar V, et al. Deterioration in the renal function and risk of microalbuminuria after radical, simple and donor nephrectomy: a long-term outcome. Urol Ann, 2016, 8(2): 184-188.
4. 周先明, 疏仁義, 郭榮利, 等. 孤立腎輸尿管結石急性梗阻伴感染的診治策略. 蚌埠醫學院學報, 2016, 41(6): 757-759.
5. Mercimet MN, Ender O. Effect of urinary stone disease and its treatment on renal function. World J Nephrol, 2015, 4(2): 271-276.
6. Dreger NM, Degener S, Ahmad-Nejad P, et al. Urosepsis-etiology, diagnosis, and treatment. Dtsch Arztebl Int, 2015, 112(49): 837-847.
7. 黃仁勝, 陳海華, 龍振河, 等. 孤立腎腎結石微創治療的現狀及進展. 醫學綜述, 2017, 23(13): 2567-2571.
8. 趙紀宇, 劉佳, 谷現恩. 孤立腎合并結石的臨床特點及其微創治療進展. 現代泌尿外科雜志, 2016, 21(6): 483-486.
9. Shokeir AA, Shoma AM, Abubieh EA, et al. Recoverability of renal function after relief of acute complete ureteral obstruction: clinical prospective study of the role of renal resistive index. Urology, 2002, 59(4): 506-510.
10. 張凱忠, 吳愛明, 潘克, 等. 急性上尿路梗阻性無尿的處理. 臨床泌尿外科雜志, 2005, 20(4): 240-241.
11. Singer M, Deutschman CS, Seymour CW, et al. The third international consensus definitions for sepsis and septic shock (sepsis-3). JAMA, 2016, 315(8): 801-810.
12. Rhodes A, Evans LE, Alhazzani W, et al. Surviving sepsis campaign: international guidelines for management of sepsis and septic shock: 2016. Crit Care Med, 2017, 45(3): 486-552.
13. 譚樂明, 楊成, 楊旭凱, 等. 尿源性膿毒血癥嚴重程度的相關因素分析. 南方醫科大學學報, 2019, 39(1): 93-99.
14. 孟祥軍, 李遜, 曾國華, 等. 孤立腎上尿路結石的微創治療. 現代泌尿外科雜志, 2006, 11(2): 89-91.
15. Kuroda S, Fujikawa A, Tabei T, et al. Retrograde intrarenal surgery for urinary stone disease in patients with solitary kidney: a retrospective analysis of the efficacy and safety. Int J Urol, 2016, 23(1): 69-73.
16. 伍宏亮. 輸尿管鏡鈥激光碎石術后尿源性膿毒血癥的危險因素分析. 中華全科醫學, 2016, 14(12): 2031-2033.
17. Kao MH, Wang CC. Risk factors for developing a perirenal hematoma after flexible ureteroscopic lithotripsy. Urol Sci, 2016, 27(3): 166-170.
18. 呂佳, 章越龍, 紀阿林, 等. 輸尿管軟鏡碎石術后腎包膜下血腫的危險因素分析. 重慶醫科大學學報, 2018, 43(4): 532-534.
19. 余偉民, 曹智修, 姚小兵, 等. 壓力灌注對不同程度積水腎損傷的評價. 武漢大學學報(醫學版), 2014, 35(6): 839-842.

West China Medical Journal

Analysis of treatment for urosepsis caused by ureteral calculi in solitary kidney

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