title: Serum creatinine predicts success in retrograde ureteral stent placement in patients with pelvic malignancies.
abstract: OBJECTIVE
  To evaluate serum hemoglobin, baseline serum creatinine, serum creatinine at the diagnosis of obstructive hydronephrosis, and the increase in serum creatinine greater than baseline to predict for success in retrograde ureteral stent placement in patients with pelvic malignancies.
  
  
  METHODS
  In a retrospective chart review, we identified 57 patients at our institution with obstructive hydronephrosis secondary to pelvic malignancies in which retrograde ureteral stent placement was attempted from January 2002 to May 2005. The patient charts were reviewed for the baseline serum creatinine, preoperative serum creatinine and hemoglobin, and serum creatinine at presentation of obstructive hydronephrosis. This population was divided into group 1 (n = 31, 54%), in which retrograde stent placement was successful, and group 2 (n = 26, 46%), in which stent placement failed and subsequent percutaneous nephrostomy tube placement was required. The Student t test was used to determine whether a significant difference existed between the two groups for each laboratory parameter.
  
  
  RESULTS
  The serum hemoglobin and baseline creatinine were not significantly different between the two groups and could not be used to predict for the success or failure of stent placement (P = 0.10 and P = 0.59, respectively). However, the average serum creatinine at presentation of obstructive hydronephrosis was significantly different between group 1 (2.4 +/- 1.4 ng/dL) and group 2 (5.3 +/- 6.3; P = 0.014), as was an increase in serum creatinine greater than baseline (P = 0.002).
  
  
  CONCLUSIONS
  The results of this study have shown that the serum creatinine level at the presentation of obstructive hydronephrosis can be used to predict for success in retrograde ureteral stent placement in patients with pelvic malignancies.
authors.affiliation: Division of Urology, Albert Einstein Medical Center, Philadelphia, Pennsylvania 19141, USA.
authors.forename: T Casey
authors.initials: TC
authors.lastname: McCullough
authors.forename: Noah R
authors.initials: NR
authors.lastname: May
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Metro
authors.forename: Phillip C
authors.initials: PC
authors.lastname: Ginsberg
authors.forename: Jamison S
authors.initials: JS
authors.lastname: Jaffe
authors.forename: Richard C
authors.initials: RC
authors.lastname: Harkaway
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002408:Catheters, Indwelling; D003404:Creatinine / Q000097:blood*; D005260:Female; D006454:Hemoglobins / Q000032:analysis*; D006801:Humans; D006869:Hydronephrosis / Q000097:blood* / Q000209:etiology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010386:Pelvic Neoplasms / Q000150:complications*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D015607:Stents
chemical_list: D006454:Hemoglobins; D003404:Creatinine