title: Associated findings and complications of retroperitoneal fibrosis in 204 patients: results of a urological registry.
abstract: OBJECTIVE
  We studied the frequency of associated findings and complications of retroperitoneal fibrosis in a large clinical collective of urological patients.
  
  
  METHODS
  All urology departments in Germany were invited to participate in a registry of patients with retroperitoneal fibrosis, for which a data sheet with more than 200 questions was developed.
  
  
  RESULTS
  As of March 2010 a total of 204 patients were registered. The male-to-female ratio was 2.1:1 and the average age at onset was 55.6 years. In 123 cases (60.3%) the diagnosis was confirmed by histopathology. Coexisting autoimmune diseases were found in 9.8% of patients, consisting mainly of thyroid disorders. Coexisting fibrosis was detected in 3.4% of the patients and 73.9% of those queried were active smokers. Of 176 patients for whom data on therapy were available 123 received monotherapy and 41 received combination therapy for a mean of 12.1 months (12 received none), while 87 underwent a total of 103 operative procedures. Hydronephrosis was the most frequent complication in 95.6% of patients. Atrophic kidney from undetected hydronephrosis appeared in 46 patients (22.5%) and in 4 bilateral damage necessitated dialysis. Complications from vascular obstruction were observed in 27.5% of patients. Large bowel obstruction requiring colostomy occurred in 4 patients (2.0%).
  
  
  CONCLUSIONS
  Patients with retroperitoneal fibrosis often first present to urology departments upon referral for hydronephrosis. In this series at least 1 kidney appeared to be irreversibly damaged in more than 20% of patients. Urologists should be mindful of the role of smoking role as a risk factor, complications arising from vascular and large bowel obstructions, and the possible association of retroperitoneal fibrosis with autoimmune disease.
authors.affiliation: Department of Urology, Helios Klinikum Wuppertal, University of Witten/Herdecke, Wuppertal, Germany. alexander-sascha.brandt@helios-kliniken.de
authors.forename: A S
authors.initials: AS
authors.lastname: Brandt
authors.forename: L
authors.initials: L
authors.lastname: Kamper
authors.forename: S
authors.initials: S
authors.lastname: Kukuk
authors.forename: P
authors.initials: P
authors.lastname: Haage
authors.forename: S
authors.initials: S
authors.lastname: Roth
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D001707:Biopsy, Needle; D015897:Comorbidity; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D006869:Hydronephrosis / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012042:Registries; D012185:Retroperitoneal Fibrosis / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D018709:Statistics, Nonparametric; D014057:Tomography, X-Ray Computed / Q000379:methods; D014572:Urology