Renal Hemodynamic Changes in Acute Ureteral Obstruction

Eun, Jong Un; Kim, Tae Kyu

Abstract

Between August 1993 and Apri1 1994, intrarenal arterial color duplex Doppler sonography was performed on 55 patients(110 kidneys) with acute ureteral obstruction and 12 patients(24 kidneys) with painless ureteral obstruction by unilateral ureteral stones to assess renal hemodynamic changes and its clinical applications. The mean resistive index(RI) of the doppler waveforms obtained on the acutely obstructed 55 kidneys(0.663+/-0.055) was significantly higher than that of the contralateral normal kidneys (0.613+/-0.052) (P<0.05). We found no RI difference between the contralateral normal 55 kidneys(mean: 0.613+/-0.052) in patients with acute ureteral obstruction and the painless obstructed 12 kidneys(mean: 0.595+/-0.029). In the acutely obstructed 55 kidneys, the mean RI of the upper pole(0.674+/-0.054) was significantly higher than that of the mid portion(0.661+/-0.064) or the lower pole(0.654+/-0.065,r<0.05). No difference of the RI was found between the hydronephrotic 31 kidneys(mean: 0.671+/-0.063) and nonhydronephrotic 24 kidneys(mean: 0.65+/-0.041) in the acutely obstructed 55 kidneys(P>0.05). There was no correlation between the levels of ureteral obstruction and intrarenal RI values(P>0.05). The RIs of 3 significantly obstructed kidneys decreased after relief of obstruction. We conclude that the RI is easily obtained and measured, and it would provide important physiological informations on renal vascular impedance in acute ureteral obstruction. Renal doppler findings could be the one of the criteria for assessing the upper urinary tract obstruction.