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

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

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, 谢院生. 先天性单肾缺失的研究现状. 中国中西医结合肾病杂志, 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, 疏仁义, 郭荣利, 等. 孤立肾输尿管结石急性梗阻伴感染的诊治策略. 蚌埠医学院学报, 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.	黄仁胜, 陈海华, 龙振河, 等. 孤立肾肾结石微创治疗的现状及进展. 医学综述, 2017, 23(13): 2567-2571.
8.	赵纪宇, 刘佳, 谷现恩. 孤立肾合并结石的临床特点及其微创治疗进展. 现代泌尿外科杂志, 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.	张凯忠, 吴爱明, 潘克, 等. 急性上尿路梗阻性无尿的处理. 临床泌尿外科杂志, 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.	谭乐明, 杨成, 杨旭凯, 等. 尿源性脓毒血症严重程度的相关因素分析. 南方医科大学学报, 2019, 39(1): 93-99.
14.	孟祥军, 李逊, 曾国华, 等. 孤立肾上尿路结石的微创治疗. 现代泌尿外科杂志, 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. 输尿管镜钬激光碎石术后尿源性脓毒血症的危险因素分析. 中华全科医学, 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.	吕佳, 章越龙, 纪阿林, 等. 输尿管软镜碎石术后肾包膜下血肿的危险因素分析. 重庆医科大学学报, 2018, 43(4): 532-534.
19.	余伟民, 曹智修, 姚小兵, 等. 压力灌注对不同程度积水肾损伤的评价. 武汉大学学报(医学版), 2014, 35(6): 839-842.

1. 王媛媛, 谢院生. 先天性单肾缺失的研究现状. 中国中西医结合肾病杂志, 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, 疏仁义, 郭荣利, 等. 孤立肾输尿管结石急性梗阻伴感染的诊治策略. 蚌埠医学院学报, 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. 黄仁胜, 陈海华, 龙振河, 等. 孤立肾肾结石微创治疗的现状及进展. 医学综述, 2017, 23(13): 2567-2571.
8. 赵纪宇, 刘佳, 谷现恩. 孤立肾合并结石的临床特点及其微创治疗进展. 现代泌尿外科杂志, 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. 张凯忠, 吴爱明, 潘克, 等. 急性上尿路梗阻性无尿的处理. 临床泌尿外科杂志, 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. 谭乐明, 杨成, 杨旭凯, 等. 尿源性脓毒血症严重程度的相关因素分析. 南方医科大学学报, 2019, 39(1): 93-99.
14. 孟祥军, 李逊, 曾国华, 等. 孤立肾上尿路结石的微创治疗. 现代泌尿外科杂志, 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. 输尿管镜钬激光碎石术后尿源性脓毒血症的危险因素分析. 中华全科医学, 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. 吕佳, 章越龙, 纪阿林, 等. 输尿管软镜碎石术后肾包膜下血肿的危险因素分析. 重庆医科大学学报, 2018, 43(4): 532-534.
19. 余伟民, 曹智修, 姚小兵, 等. 压力灌注对不同程度积水肾损伤的评价. 武汉大学学报(医学版), 2014, 35(6): 839-842.

West China Medical Journal

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

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content