Long-term renal dysfunction in patients with acute urinary retention.
OBJECTIVE
Acute urinary retention (AUR) causes bilateral renal obstruction, which has been found to affect kidney function. This study evaluated both glomerular and tubular renal function in the long term after the resolution of AUR.


METHODS
Renal function in 15 patients affected by AUR and found still to evince renal dysfunction 6 months afterwards was re-evaluated approximately 18 months after the episode. The bladder outlet obstruction was treated and all patients voided normally at 6 month control.


RESULTS
The percentage of patients suffering from lowered creatinine clearance and elevated alpha1-microglobulin excretion increased during follow-up from AUR up to 6 and 18 months (46% to 57% to 79% and 42% to 71% to 100%, respectively). In addition, daily protein excretion was abnormally high in 69% of patients at the 18 month follow-up. In most cases the abnormalities found in renal function were mild.


CONCLUSIONS
Patients evincing renal dysfunction 6 months after AUR showed permanent impairment in tubular function, whereas glomerular permeability had partially recovered. Although this may be explained in part by chronic obstruction prior to AUR and although the impairment was mild in most cases, these findings stress the importance of urgent treatment of AUR to avoid the development of renal failure.
Mustonen
S
S
Division of Urology, Tampere University Hospital, Finland. s.musto@fimnet.fi
Ala-Houhala
I O
IO
Tammela
T L
TL
D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006801:Humans; D007674:Kidney Diseases / Q000175:diagnosis / Q000209:etiology*; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D014546:Urinary Catheterization; D016055:Urinary Retention / Q000150:complications* / Q000175:diagnosis / Q000628:therapy*