The study aims to evaluate the incidence and factors associated with acute kidney injury (AKI) among patients presenting with ureteric calculi. We also intend to study the impact of time delay since first symptom to presentation to our hospital among patients with ureteric calculi and its influence on AKI.
The study is a prospective observational study and included all symptomatic ureteric calculi patients. AKI was defined as per the KDIGO guidelines. All the patients diagnosed with ureteric calculi were grouped into those having an episode of AKI and those without an episode on AKI.
The incidence of AKI in our study was 14.63% (18 patients) among 123 patients of ureteric calculi. Average time delay from time of diagnosis to presentation among patients with AKI was 31.7±6.2 days (mean ± S.D) as compared to 19.5±5.7 (mean ± S.D) days among all cases. Factors which were significantly associated with AKI in patients with ureteric calculi include time delay, diabetes mellitus, bilateral ureteric calculi, stone size greater than 10 mm, solitary functioning kidney and urine culture showing gram negative growth. Fifty percent of the AKI group eventual required nephrectomy of one renal unit.
This study will help us streamline our resources predominantly towards those patients who present with factors associated with increased risk of AKI. As the time delay to presentation in patients with AKI with ureteric calculi is significantly higher, it is imperative to counsel patients with stone disease.
Urology annals. 0000 Jan [Epub]
Sheshang Uday Kamath, Bhushan Patil, Sujata Kiran Patwardhan
Department of Urology, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India.