Comparison of percutaneous nephrostomy and double j stent in early normalization of renal function tests in patients with obstructive uropathy due to urolithiasis
Objective: To compare the mean normalization period of serum levels of urea and creatinine after placement of PCN tube or a DJ stent as emergency management for obstructive uropathy due to urolithiasis.
Methodology: A randomized controlled trial study is conducted in the Institute of Kidney Diseases, Hayatabad Medical Complex Peshawar from March 2018 - March 2019. The total sample of 416 was divided into two groups by the lottery method. Group A comprising of 208 patients who underwent Percutaneous Nephrostomy (PCN) and Group B Comprising of 208 in who underwent Double J Stenting for the relief of the obstructive uropathy respectively. Serum levels of urea and creatinine were recorded at 24, 96 and 144 hours post-operatively.
Results: The mean age of Group A 35.6 ± 8.4 years and the Mean age in Group B was 38.2± 10.4 years. The majority (76.6%) participants were male, including 70% were from PCN group and 79% were from DJ group. The time taken for normalization of serum urea level was 97.654 hours (4.068 days) and 106.453 hours (4.435 days) in the PCN and DJ stenting groups respectively. The normalization time of serum creatinine level was 95.4375 hours (3.98 days) and 104.8125 hours (4.36 days) in the patients undergoing PCN and DJ stenting respectively. The differences of normalization time in both groups were not statistically significant with p-values of 0.064 and 0.061 for normalization of serum urea and creatinine levels respectively.
Conclusion: Both the PCN and DJ stenting methods were equally effective in stone management in obstructive uropathy patients for normalization of elevated serum urea and creatinine levels.
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