Successful use of steroids and ureteric stents in 24 patients with idiopathic retroperitoneal fibrosis: a retrospective study.
OBJECTIVE
Retroperitoneal fibrosis (RPF) is a chronic inflammatory disorder causing obstructive nephropathy and renal failure. We reviewed our management of this condition.


METHODS
All patients with RPF treated at a single center over a 15-year period were identified. A full review of notes and computer records was undertaken.


RESULTS
Data was available on 27 patients, 3 of which were excluded from later analysis. Diagnosis was based on clinical history and cross-sectional imaging. Retroperitoneal biopsy was undertaken in 3 patients. 96% had significant renal impairment at presentation with a mean serum creatinine of 688 micromol/l. 46% required emergency hemodialysis. All patients were treated with a combination of ureteric stents and/or steroids with an excellent clinical response. The mean best creatinine reached by the cohort was 136 micromol/l, and renal function remained stable in the long term. No patients required chronic dialysis. Ureteric stents were removed within 12 months and low-dose steroids were continued for a mean of 34 months. Recurrent disease was observed in 25% of patients, who all responded well to further steroid therapy. Mean duration of follow-up was 76 months.


CONCLUSIONS
RPF is very effectively treated by a combination of ureteric stents and steroids, with excellent long-term results using this approach. Continued follow-up is advised because of the possibility of recurrent disease.
Fry
Andrew C
AC
Department of Nephrology, Lister Hospital, Stevenage, UK. andyfry@doctors.org.uk
Singh
Sadmeet
S
Gunda
Smita S
SS
Boustead
Greg B
GB
Hanbury
Damian C
DC
McNicholas
Thomas A
TA
Farrington
Ken
K
D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012185:Retroperitoneal Fibrosis / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D012189:Retrospective Studies; D013256:Steroids / Q000627:therapeutic use*; D016896:Treatment Outcome; D014513:Ureter / Q000601:surgery*; D014517:Ureteral Obstruction / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*
D000893:Anti-Inflammatory Agents; D013256:Steroids