Abstract: PUB003
Early Urinary Diversion Is Associated with Reduced Dialysis Requirement in Obstructive Uropathy-Related AKI: A Retrospective Cohort from the Philippines
Session Information
Category: Acute Kidney Injury
- 102 AKI: Clinical, Outcomes, and Trials
Authors
- Senga, Ferdinand Miguel, Northern Mindanao Medical Center, Cagayan de Oro, Northern Mindanao, Philippines
- Comonsad, Renee Glorien Espiga, Northern Mindanao Medical Center, Cagayan de Oro, Northern Mindanao, Philippines
Background
Obstructive uropathy is a potentially reversible cause of acute kidney injury (AKI), but delayed decompression may lead to permanent renal injury and dialysis dependence. Comparative outcome data from low- and middle-income settings are limited.
Methods
We retrospectively reviewed adults admitted from January–June 2024 to a tertiary referral hospital in Northern Mindanao, Philippines, with AKI secondary to obstructive uropathy who underwent urinary diversion by double-J stenting (DJ) or percutaneous nephrostomy (PCN). Outcomes included post-procedure creatinine, eGFR, and hemodialysis requirement. Early intervention was defined as diversion before development of uremic manifestations or suspected irreversible kidney injury; late intervention after these findings. Associations were tested using chi-square analysis.
Results
Fifty-nine patients were included; 42 underwent DJ stenting and 17 underwent PCN. Urinary calculi were the leading cause of obstruction, followed by malignancy-related compression. Most patients underwent early diversion (76.3%). Diversion modality was not significantly associated with creatinine recovery, eGFR improvement, or dialysis requirement. In contrast, timing of intervention significantly influenced dialysis need. Patients managed early were substantially less likely to require hemodialysis than those managed late (p=0.001).
Conclusion
Among patients with obstructive uropathy–associated AKI, early decompression was associated with lower dialysis requirement, while procedure type did not significantly affect renal recovery. These findings support expedited diagnosis and urgent urinary diversion to improve kidney outcomes.