Obstructive acute renal failure is both a medical and a surgical emergency. The first treatment modality is urological by relief of obstruction. Post-obstructive diuresis is an abnormal condition of prolonged polyuria...Obstructive acute renal failure is both a medical and a surgical emergency. The first treatment modality is urological by relief of obstruction. Post-obstructive diuresis is an abnormal condition of prolonged polyuria, involving both excessive solute and water loss, after acute drainage of obstructed urinary tract system. Physiopathology mechanisms are multiples. In most patients, diuresis will resolve once the kidneys normalize the volume and solute status and homeostasis is achieved. Post-obstructive diuresis can occur in up to 50% of patients with substantial urinary tract obstruction and can be life-threatening if it becomes pathologic. It can be detected by hourly monitoring of diuresis. Medical treatment of post-obstructive diuresis consists of oral or intravenous fluids adjusted to the findings of clinical examination, diuresis (volume and electrolytes) and close monitoring of patient. Fluid compensation should be tapered off over several days. Patients at high risk of post-obstructive diuresis should be identified and appropriately monitored.展开更多
Obstructive uropathy is an important cause of acute and chronic kidney disease.Decompression of the urinary tract is an essential aspect of treatment.The cause and aetiology of obstruction typically determine the surg...Obstructive uropathy is an important cause of acute and chronic kidney disease.Decompression of the urinary tract is an essential aspect of treatment.The cause and aetiology of obstruction typically determine the surgical approach.Acute relief of obstruction is frequently complicated by fluid and electrolyte imbalance.Standard therapeutic interventions for acute or chronic renal failure also apply for cases of obstructive uropathy.This narrative review summarises the early and long-term medical management of obstructive uropathy.展开更多
文摘Obstructive acute renal failure is both a medical and a surgical emergency. The first treatment modality is urological by relief of obstruction. Post-obstructive diuresis is an abnormal condition of prolonged polyuria, involving both excessive solute and water loss, after acute drainage of obstructed urinary tract system. Physiopathology mechanisms are multiples. In most patients, diuresis will resolve once the kidneys normalize the volume and solute status and homeostasis is achieved. Post-obstructive diuresis can occur in up to 50% of patients with substantial urinary tract obstruction and can be life-threatening if it becomes pathologic. It can be detected by hourly monitoring of diuresis. Medical treatment of post-obstructive diuresis consists of oral or intravenous fluids adjusted to the findings of clinical examination, diuresis (volume and electrolytes) and close monitoring of patient. Fluid compensation should be tapered off over several days. Patients at high risk of post-obstructive diuresis should be identified and appropriately monitored.
文摘Obstructive uropathy is an important cause of acute and chronic kidney disease.Decompression of the urinary tract is an essential aspect of treatment.The cause and aetiology of obstruction typically determine the surgical approach.Acute relief of obstruction is frequently complicated by fluid and electrolyte imbalance.Standard therapeutic interventions for acute or chronic renal failure also apply for cases of obstructive uropathy.This narrative review summarises the early and long-term medical management of obstructive uropathy.
