Cervical cancer: Renal complications and survival after percutaneous nephrostomy.
BACKGROUND
Obstructive nephropathy is a frequent complication in the course of advanced cervical cancer (CC), and ultrasonography-guided percutaneous nephrostomy (PCN) is a well established technique for fast ureteral desobstruction.


OBJECTIVE
To identify possible factors related to the survival and quality of life of patients with advanced CC presenting acute urinary obstructive complications that after desobstruction by PCN recovered urinary flux and renal function.


METHODS
This is an analytical, descriptive, cross-sectional study that included 45 patients with CC who underwent PCN and were divided into 2 groups: "death" (DG) and "survival" (SG), in a public hospital that is reference for oncologic diseases in Northern Brazil.


RESULTS
The mean serum creatinine of the patients preceding PCN was >10 mg/dL, and after PCN <2 mg/dL. The cutoffs of 8.7 g/dL for Hb (p=0.0241) and 27% for Ht (p=0.0065) indicated the values that better discriminate the outcomes of the groups. The presence of low blood pressure was statistically correlated (p=0.0037) to the outcome "death". Changes in glomerular filtration rate (already reduced in all cases) were not associated to the levels of Hb/Ht or to the outcome "death" during the nephrological follow-up.


CONCLUSIONS
PCN was responsible for the recovery of renal function in 61.7% of the patients, leading to interruption of renal replacement therapy (RRT) in all of those patients. Hb levels >8.7g/dL and Ht >27% were associated to longer survival, and the presence of low blood pressure during follow-up was associated with progression to death.
Universidade Federal de São Paulo, Universidade Federal de São Paulo, Department of Medicine, São Paulo SP , Brazil, MD, MSc, Department of Medicine of the Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brazil.
Alzira Carvalho Paula de
AC
Souza
Universidade Federal de São Paulo, Unifesp, Department of Medicine, São Paulo SP , Brazil, MD, Department of Medicine of Unifesp, São Paulo, SP, Brazil.
Alfredo Nunes
AN
Souza
Universidade Federal de São Paulo, Unifesp, Department of Medicine, São Paulo SP , Brazil, MD, Department of Medicine of Unifesp, São Paulo, SP, Brazil.
Rubens
R
Kirsztajn
Universidade Federal de São Paulo, Unifesp, Department of Medicine, São Paulo SP , Brazil, MD, PhD, Department of Medicine of Unifesp, São Paulo, SP, Brazil.
Gianna Mastroianni
GM
Kirsztajn
D000328:Adult; D000367:Age Factors; D000368:Aged; D003404:Creatinine / Q000097:blood; D004812:Epidemiologic Methods; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007674:Kidney Diseases / Q000209:etiology* / Q000401:mortality* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous / Q000401:mortality*; D011788:Quality of Life; D012737:Sex Factors; D016896:Treatment Outcome; D014517:Ureteral Obstruction / Q000209:etiology / Q000401:mortality / Q000601:surgery; D002583:Uterine Cervical Neoplasms / Q000150:complications* / Q000401:mortality*
D003404:Creatinine