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Khandelwal S, Dhande R, Sood A, Parihar P, Mishra GV. Role of Multidetector Computed Tomography Urography in the Evaluation of Obstructive Uropathy: A Review. Cureus 2023; 15:e48038. [PMID: 38034148 PMCID: PMC10688237 DOI: 10.7759/cureus.48038] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 10/30/2023] [Indexed: 12/02/2023] Open
Abstract
Obstructive uropathy, a prevalent clinical problem, can irreparably harm the kidneys if not treated promptly. As a result, accurate diagnosis is necessary for prompt management. This study examines the utility of multidetector computed tomography (MDCT) urography in identifying obstructive uropathy. PubMed, Google, Embase, Medline, and other electronic databases were used to search the English-language literature. The search phrases were obstructive urinary infections or urinary bladder or kidneys or MDCT. The authors' expertise and experience in the subject area aided in archiving pertinent publications. Even though the dilated upper tract of the ureters can be seen, ultrasonography (USG) has limitations because it cannot show the middle portion of the ureters, even if they are dilated mostly due to bowel gas artifacts. The USG does not emphasize the functioning of the renal tract. To evaluate obstructive uropathy, MDCT urography plays a very important role. For speedy, effective therapy, it provides a quick diagnosis of the source of obstruction.
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Affiliation(s)
- Shreya Khandelwal
- Radiodiagnosis, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Rajasbala Dhande
- Radiodiagnosis, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Anshul Sood
- Radiodiagnosis, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Pratapsingh Parihar
- Radiodiagnosis, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Gaurav V Mishra
- Radiodiagnosis, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Halle MPE, Chipekam NM, Beyiha G, Fouda H, Coulibaly A, Hentchoya R, Kaze FF, Luma NH, Ashuntantang G. Incidence, characteristics and prognosis of acute kidney injury in Cameroon: a prospective study at the Douala General Hospital. Ren Fail 2018; 40:30-37. [PMID: 29285953 PMCID: PMC6014289 DOI: 10.1080/0886022x.2017.1419970] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Objective: There are limited data on AKI in sub-Saharan Africa. We aim to determine the incidence, characteristics and prognosis of AKI in Cameroon. Patients and methods: A prospective study including all consenting acute admissions in the internal medicine and the ICU of a tertiary referral hospital in Cameroon from January 2015 to June 2016. Serum creatinine assay was done on admission, days 2 and 7 to diagnose AKI. For patients with AKI, serum creatinine was done on discharge, days 30, 60 and 90. AKI was defined according to the modified KDIGO 2012 criteria as an increase or decrease in serum creatinine of 3 mg/l or greater, or an increase of 50% or more from the reference value obtained at admission or the known baseline value. AKI severity was graded using KDIGO2012 criteria. Outcome measures were renal recovery, mortality and causes of death. Renal recovery was complete if serum creatinine between the first 90 days was less than baseline or reference, partial if less than diagnosis but not baseline or reference, no-recovery if creatinine did not decrease or if the patient remained on dialysis. Results: Of the 2402 patients included, 536 developed AKI giving a global incidence of 22.3% and annual incidence of 15 per 100 patients-years. Of the 536 patients with AKI, 43.3% were at stage 3, 54.7% were males, median age was 56 years. Pre-renal AKI (61.4%) and acute tubular necrosis (28.9%) were the most frequent forms. Main etiologies were sepsis (50.4%) and volume depletion (31.6%). Renal outcome was unknown in 34% of patients. Of the 354 patients with known renal function at 3 months, 84.2% recovered completely, 14.7% partially and 1.1% progressed to CKD. Global mortality rate was 36.9% mainly due to sepsis. Conclusions: AKI is frequent in our setting, mainly due to sepsis and hypovolemia. It carries a poor prognosis.
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Affiliation(s)
- Marie Patrice E Halle
- a Faculty of Medicine and Pharmaceutical Sciences , University of Douala , Douala , Cameroon.,b Department of Internal Medicine , Douala General Hospital , Douala , Cameroon
| | | | - Gérard Beyiha
- a Faculty of Medicine and Pharmaceutical Sciences , University of Douala , Douala , Cameroon.,c Intensive Care Unit , Douala General Hospital , Douala , Cameroon
| | - Hermine Fouda
- b Department of Internal Medicine , Douala General Hospital , Douala , Cameroon.,d Faculty of Medicine and Biomedical Sciences , University of Yaounde , Yaounde , Cameroon
| | | | | | - Folefack Francois Kaze
- d Faculty of Medicine and Biomedical Sciences , University of Yaounde , Yaounde , Cameroon
| | - Namme Henry Luma
- b Department of Internal Medicine , Douala General Hospital , Douala , Cameroon.,d Faculty of Medicine and Biomedical Sciences , University of Yaounde , Yaounde , Cameroon
| | - Gloria Ashuntantang
- b Department of Internal Medicine , Douala General Hospital , Douala , Cameroon.,d Faculty of Medicine and Biomedical Sciences , University of Yaounde , Yaounde , Cameroon
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