Yaxley J, Yaxley W. Obstructive uropathy – acute and chronic medical management. World J Nephrol 2023; 12(1): 1-9 [PMID: 36704657 DOI: 10.5527/wjn.v12.i1.1]
Corresponding Author of This Article
Julian Yaxley, MBBS, FRACP, Doctor, Division of Medicine, Queensland Health, 33 Charlotte Street, Brisbane 4001, QLD, Australia. julianyaxley@yahoo.com.au
Research Domain of This Article
Urology & Nephrology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Nephrol. Jan 25, 2023; 12(1): 1-9 Published online Jan 25, 2023. doi: 10.5527/wjn.v12.i1.1
Obstructive uropathy – acute and chronic medical management
Julian Yaxley, William Yaxley
Julian Yaxley, Division of Medicine, Queensland Health, Brisbane 4001, QLD, Australia
Julian Yaxley, School of Medicine and Dentistry, Griffith University, Southport 4215, Australia
William Yaxley, Department of Urology, Queen Elizabeth II Jubilee Hospital, Coopers Plains, 4108, Australia
Author contributions: Yaxley J conceived, researched, and drafted the manuscript; Yaxley W researched and drafted the manuscript.
Conflict-of-interest statement: The authors declare no conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Julian Yaxley, MBBS, FRACP, Doctor, Division of Medicine, Queensland Health, 33 Charlotte Street, Brisbane 4001, QLD, Australia. julianyaxley@yahoo.com.au
Received: August 31, 2022 Peer-review started: August 31, 2022 First decision: September 27, 2022 Revised: October 27, 2022 Accepted: December 21, 2022 Article in press: December 21, 2022 Published online: January 25, 2023
Abstract
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.
Core Tip: Obstructive uropathy is a prevalent cause of acute and chronic kidney disease. Urinary tract decompression is the single most beneficial aspect of management; renal impairment is frequently reversible and the long-term renal prognosis is generally excellent. Subsequent medical care is an important but underappreciated supplement to surgical treatment. Acute relief of obstruction is often complicated by disorders of sodium and potassium balance and post-obstructive diuresis. Longer-term management principles are similar to those for other forms of chronic kidney disease.
