Can kidneys be saved in patients with urinary tuberculosis? A study in the era of modern chemotherapy and surgical armamentarium
Objective To assess renal unit survival and factors affecting renal salvageability in a cohort of patients receiving modern medical and surgical therapy for urinary tuberculosis. Methods This was a retrospective single‐center study including all patients diagnosed and treated as urinary tuberculosis...
Gespeichert in:
| Veröffentlicht in: | International journal of urology 2019-05, Vol.26 (5), p.551-557 |
|---|---|
| Hauptverfasser: | , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 557 |
|---|---|
| container_issue | 5 |
| container_start_page | 551 |
| container_title | International journal of urology |
| container_volume | 26 |
| creator | Kumar, Amar Dangi, Anuj D Mukha, Rajiv P Panda, Arabind Jeychandraberry, Chandrasingh Kumar, Santosh Devasia, Antony Kekre, Nitin S |
| description | Objective
To assess renal unit survival and factors affecting renal salvageability in a cohort of patients receiving modern medical and surgical therapy for urinary tuberculosis.
Methods
This was a retrospective single‐center study including all patients diagnosed and treated as urinary tuberculosis between 2005 and 2015 at Christian Medical College, Vellore, Tamil Nadu, India. The primary outcome was time to renal unit non‐salvageability (estimated glomerular filtration rate of 15 mL/min had fivefold the survival estimate as compared with those ≤15 mL/min (P |
| doi_str_mv | 10.1111/iju.13926 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2186152955</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2213550572</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3776-f48639d1c845065810b06a55ef1f7ea0de1582abc9bd44d4d198d302eca5ef1e3</originalsourceid><addsrcrecordid>eNp10U1r3DAQBmBRGppt0kP_QBnopTk40Yflj1MJS9MmBHJJzkKWxl1tbXkrWQm-9adXm017KHQuguHhRcxLyHtGz1meC7dN50y0vHpFVqwsecFpyV-TFW1ZWzSs5sfkbYxbSpngrHlDjgVtqKCSr8ivtfbww1mPS4QOIepHtOA87PTs0M8Rnty8gRSc12GBOXUYTBqm6OJnuIQ4J7vs-bxBwKBh6mGcLAYPZoPjlNdB7xbQ3kJM4bszegAdRj3mbB1cGk_JUa-HiO9e3hPycPXlfv2tuL37er2-vC2MqOuq6MumEq1lpiklrWTDaEcrLSX2rK9RU4tMNlx3pu1sWdrSsraxgnI0em9QnJBPh9xdmH4mjLMaXTQ4DNrjlKLKh6mY5K2UmX78h26nFHz-neKcCSmprHlWZwdlwhRjwF7tghvzkRSjal-LyrWo51qy_fCSmLoR7V_5p4cMLg7gyQ24_D9JXd88HCJ_A0KZl_0</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2213550572</pqid></control><display><type>article</type><title>Can kidneys be saved in patients with urinary tuberculosis? A study in the era of modern chemotherapy and surgical armamentarium</title><source>Wiley Online Library Journals Frontfile Complete</source><creator>Kumar, Amar ; Dangi, Anuj D ; Mukha, Rajiv P ; Panda, Arabind ; Jeychandraberry, Chandrasingh ; Kumar, Santosh ; Devasia, Antony ; Kekre, Nitin S</creator><creatorcontrib>Kumar, Amar ; Dangi, Anuj D ; Mukha, Rajiv P ; Panda, Arabind ; Jeychandraberry, Chandrasingh ; Kumar, Santosh ; Devasia, Antony ; Kekre, Nitin S</creatorcontrib><description>Objective
To assess renal unit survival and factors affecting renal salvageability in a cohort of patients receiving modern medical and surgical therapy for urinary tuberculosis.
Methods
This was a retrospective single‐center study including all patients diagnosed and treated as urinary tuberculosis between 2005 and 2015 at Christian Medical College, Vellore, Tamil Nadu, India. The primary outcome was time to renal unit non‐salvageability (estimated glomerular filtration rate of <15 mL/min).
Results
A total of 128 patients were included in the study. The mean age was 37.7 ± 11.3 years, 33% had microbiological and 73% had histopathological confirmation in addition to radiological diagnosis. The estimated median survival of the involved renal units (n = 187) on Kaplan–Meier estimate was 75 months (95% CI 39–99). On multivariate analysis, renal units with initial split function >15 mL/min had fivefold the survival estimate as compared with those ≤15 mL/min (P < 0.001); the presence of one, two and three infundibular strictures had a 2.2‐, 2.9‐ and fivefold higher hazard of renal unit loss respectively, and lower ureteric strictures had fivefold longer estimated survival (P = 0.015) after treatment. Renal units in the reconstruction group had 5.44‐fold (95% CI 2.71–10.88, P < 0.001) longer survival than the permanent diversion group, with a mean change in split function of +0.76 (±16.11) mL/min, versus −5.61 (±10.87) mL/min respectively.
Conclusions
Loss of renal units is a function of time despite modern treatment. Baseline renal unit function, site of ureteric involvement and extent of infundibular involvement on imaging are helpful in predicting the duration of renal salvageability. When feasible, reconstruction is better at renal function preservation.</description><identifier>ISSN: 0919-8172</identifier><identifier>EISSN: 1442-2042</identifier><identifier>DOI: 10.1111/iju.13926</identifier><identifier>PMID: 30803052</identifier><language>eng</language><publisher>Australia: Wiley Subscription Services, Inc</publisher><subject>Chemotherapy ; Glomerular filtration rate ; Multivariate analysis ; nephrectomy ; Patients ; Preservation ; reconstruction ; Renal function ; renal unit salvage ; Stricture ; Survival ; survival analysis ; Tuberculosis ; Ureter ; urinary tuberculosis</subject><ispartof>International journal of urology, 2019-05, Vol.26 (5), p.551-557</ispartof><rights>2019 The Japanese Urological Association</rights><rights>2019 The Japanese Urological Association.</rights><rights>Copyright © 2019 The Japanese Urological Association</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3776-f48639d1c845065810b06a55ef1f7ea0de1582abc9bd44d4d198d302eca5ef1e3</citedby><cites>FETCH-LOGICAL-c3776-f48639d1c845065810b06a55ef1f7ea0de1582abc9bd44d4d198d302eca5ef1e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fiju.13926$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fiju.13926$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,777,781,1412,27905,27906,45555,45556</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30803052$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kumar, Amar</creatorcontrib><creatorcontrib>Dangi, Anuj D</creatorcontrib><creatorcontrib>Mukha, Rajiv P</creatorcontrib><creatorcontrib>Panda, Arabind</creatorcontrib><creatorcontrib>Jeychandraberry, Chandrasingh</creatorcontrib><creatorcontrib>Kumar, Santosh</creatorcontrib><creatorcontrib>Devasia, Antony</creatorcontrib><creatorcontrib>Kekre, Nitin S</creatorcontrib><title>Can kidneys be saved in patients with urinary tuberculosis? A study in the era of modern chemotherapy and surgical armamentarium</title><title>International journal of urology</title><addtitle>Int J Urol</addtitle><description>Objective
To assess renal unit survival and factors affecting renal salvageability in a cohort of patients receiving modern medical and surgical therapy for urinary tuberculosis.
Methods
This was a retrospective single‐center study including all patients diagnosed and treated as urinary tuberculosis between 2005 and 2015 at Christian Medical College, Vellore, Tamil Nadu, India. The primary outcome was time to renal unit non‐salvageability (estimated glomerular filtration rate of <15 mL/min).
Results
A total of 128 patients were included in the study. The mean age was 37.7 ± 11.3 years, 33% had microbiological and 73% had histopathological confirmation in addition to radiological diagnosis. The estimated median survival of the involved renal units (n = 187) on Kaplan–Meier estimate was 75 months (95% CI 39–99). On multivariate analysis, renal units with initial split function >15 mL/min had fivefold the survival estimate as compared with those ≤15 mL/min (P < 0.001); the presence of one, two and three infundibular strictures had a 2.2‐, 2.9‐ and fivefold higher hazard of renal unit loss respectively, and lower ureteric strictures had fivefold longer estimated survival (P = 0.015) after treatment. Renal units in the reconstruction group had 5.44‐fold (95% CI 2.71–10.88, P < 0.001) longer survival than the permanent diversion group, with a mean change in split function of +0.76 (±16.11) mL/min, versus −5.61 (±10.87) mL/min respectively.
Conclusions
Loss of renal units is a function of time despite modern treatment. Baseline renal unit function, site of ureteric involvement and extent of infundibular involvement on imaging are helpful in predicting the duration of renal salvageability. When feasible, reconstruction is better at renal function preservation.</description><subject>Chemotherapy</subject><subject>Glomerular filtration rate</subject><subject>Multivariate analysis</subject><subject>nephrectomy</subject><subject>Patients</subject><subject>Preservation</subject><subject>reconstruction</subject><subject>Renal function</subject><subject>renal unit salvage</subject><subject>Stricture</subject><subject>Survival</subject><subject>survival analysis</subject><subject>Tuberculosis</subject><subject>Ureter</subject><subject>urinary tuberculosis</subject><issn>0919-8172</issn><issn>1442-2042</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><recordid>eNp10U1r3DAQBmBRGppt0kP_QBnopTk40Yflj1MJS9MmBHJJzkKWxl1tbXkrWQm-9adXm017KHQuguHhRcxLyHtGz1meC7dN50y0vHpFVqwsecFpyV-TFW1ZWzSs5sfkbYxbSpngrHlDjgVtqKCSr8ivtfbww1mPS4QOIepHtOA87PTs0M8Rnty8gRSc12GBOXUYTBqm6OJnuIQ4J7vs-bxBwKBh6mGcLAYPZoPjlNdB7xbQ3kJM4bszegAdRj3mbB1cGk_JUa-HiO9e3hPycPXlfv2tuL37er2-vC2MqOuq6MumEq1lpiklrWTDaEcrLSX2rK9RU4tMNlx3pu1sWdrSsraxgnI0em9QnJBPh9xdmH4mjLMaXTQ4DNrjlKLKh6mY5K2UmX78h26nFHz-neKcCSmprHlWZwdlwhRjwF7tghvzkRSjal-LyrWo51qy_fCSmLoR7V_5p4cMLg7gyQ24_D9JXd88HCJ_A0KZl_0</recordid><startdate>201905</startdate><enddate>201905</enddate><creator>Kumar, Amar</creator><creator>Dangi, Anuj D</creator><creator>Mukha, Rajiv P</creator><creator>Panda, Arabind</creator><creator>Jeychandraberry, Chandrasingh</creator><creator>Kumar, Santosh</creator><creator>Devasia, Antony</creator><creator>Kekre, Nitin S</creator><general>Wiley Subscription Services, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>7X8</scope></search><sort><creationdate>201905</creationdate><title>Can kidneys be saved in patients with urinary tuberculosis? A study in the era of modern chemotherapy and surgical armamentarium</title><author>Kumar, Amar ; Dangi, Anuj D ; Mukha, Rajiv P ; Panda, Arabind ; Jeychandraberry, Chandrasingh ; Kumar, Santosh ; Devasia, Antony ; Kekre, Nitin S</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3776-f48639d1c845065810b06a55ef1f7ea0de1582abc9bd44d4d198d302eca5ef1e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Chemotherapy</topic><topic>Glomerular filtration rate</topic><topic>Multivariate analysis</topic><topic>nephrectomy</topic><topic>Patients</topic><topic>Preservation</topic><topic>reconstruction</topic><topic>Renal function</topic><topic>renal unit salvage</topic><topic>Stricture</topic><topic>Survival</topic><topic>survival analysis</topic><topic>Tuberculosis</topic><topic>Ureter</topic><topic>urinary tuberculosis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kumar, Amar</creatorcontrib><creatorcontrib>Dangi, Anuj D</creatorcontrib><creatorcontrib>Mukha, Rajiv P</creatorcontrib><creatorcontrib>Panda, Arabind</creatorcontrib><creatorcontrib>Jeychandraberry, Chandrasingh</creatorcontrib><creatorcontrib>Kumar, Santosh</creatorcontrib><creatorcontrib>Devasia, Antony</creatorcontrib><creatorcontrib>Kekre, Nitin S</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>International journal of urology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kumar, Amar</au><au>Dangi, Anuj D</au><au>Mukha, Rajiv P</au><au>Panda, Arabind</au><au>Jeychandraberry, Chandrasingh</au><au>Kumar, Santosh</au><au>Devasia, Antony</au><au>Kekre, Nitin S</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Can kidneys be saved in patients with urinary tuberculosis? A study in the era of modern chemotherapy and surgical armamentarium</atitle><jtitle>International journal of urology</jtitle><addtitle>Int J Urol</addtitle><date>2019-05</date><risdate>2019</risdate><volume>26</volume><issue>5</issue><spage>551</spage><epage>557</epage><pages>551-557</pages><issn>0919-8172</issn><eissn>1442-2042</eissn><abstract>Objective
To assess renal unit survival and factors affecting renal salvageability in a cohort of patients receiving modern medical and surgical therapy for urinary tuberculosis.
Methods
This was a retrospective single‐center study including all patients diagnosed and treated as urinary tuberculosis between 2005 and 2015 at Christian Medical College, Vellore, Tamil Nadu, India. The primary outcome was time to renal unit non‐salvageability (estimated glomerular filtration rate of <15 mL/min).
Results
A total of 128 patients were included in the study. The mean age was 37.7 ± 11.3 years, 33% had microbiological and 73% had histopathological confirmation in addition to radiological diagnosis. The estimated median survival of the involved renal units (n = 187) on Kaplan–Meier estimate was 75 months (95% CI 39–99). On multivariate analysis, renal units with initial split function >15 mL/min had fivefold the survival estimate as compared with those ≤15 mL/min (P < 0.001); the presence of one, two and three infundibular strictures had a 2.2‐, 2.9‐ and fivefold higher hazard of renal unit loss respectively, and lower ureteric strictures had fivefold longer estimated survival (P = 0.015) after treatment. Renal units in the reconstruction group had 5.44‐fold (95% CI 2.71–10.88, P < 0.001) longer survival than the permanent diversion group, with a mean change in split function of +0.76 (±16.11) mL/min, versus −5.61 (±10.87) mL/min respectively.
Conclusions
Loss of renal units is a function of time despite modern treatment. Baseline renal unit function, site of ureteric involvement and extent of infundibular involvement on imaging are helpful in predicting the duration of renal salvageability. When feasible, reconstruction is better at renal function preservation.</abstract><cop>Australia</cop><pub>Wiley Subscription Services, Inc</pub><pmid>30803052</pmid><doi>10.1111/iju.13926</doi><tpages>7</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0919-8172 |
| ispartof | International journal of urology, 2019-05, Vol.26 (5), p.551-557 |
| issn | 0919-8172 1442-2042 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2186152955 |
| source | Wiley Online Library Journals Frontfile Complete |
| subjects | Chemotherapy Glomerular filtration rate Multivariate analysis nephrectomy Patients Preservation reconstruction Renal function renal unit salvage Stricture Survival survival analysis Tuberculosis Ureter urinary tuberculosis |
| title | Can kidneys be saved in patients with urinary tuberculosis? A study in the era of modern chemotherapy and surgical armamentarium |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-18T23%3A32%3A42IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Can%20kidneys%20be%20saved%20in%20patients%20with%20urinary%20tuberculosis?%20A%20study%20in%20the%20era%20of%20modern%20chemotherapy%20and%20surgical%20armamentarium&rft.jtitle=International%20journal%20of%20urology&rft.au=Kumar,%20Amar&rft.date=2019-05&rft.volume=26&rft.issue=5&rft.spage=551&rft.epage=557&rft.pages=551-557&rft.issn=0919-8172&rft.eissn=1442-2042&rft_id=info:doi/10.1111/iju.13926&rft_dat=%3Cproquest_cross%3E2213550572%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2213550572&rft_id=info:pmid/30803052&rfr_iscdi=true |