Pressure matters: intrarenal pressures during normal and pathological conditions, and impact of increased values to renal physiology

被引:185
作者
Tokas, Theodoros [1 ]
Herrmann, Thomas R. W. [2 ]
Skolarikos, Andreas [3 ]
Nagele, Udo [1 ]
机构
[1] Gen Hosp Hall In Tirol, Dept Urol & Androl, Milser Str 10, A-6060 Hall In Tirol, Austria
[2] Spital Thurgau AG, Kantonspital Frauenfeld, Dept Urol, Frauenfeld, Switzerland
[3] Athens Med Sch, Sismanoglio Hosp, Dept Urol 2, Athens, Greece
关键词
Percutaneous nephrolithotomy; PCNL; Ureteroscopy; URS; RIRS; Irrigation flow; Irrigation pressure; Intrarenal pressure; Intrapelvic pressure; Renal pelvic pressure; UPPER URINARY-TRACT; PERCUTANEOUS ULTRASONIC LITHOTRIPSY; INFLAMMATORY RESPONSE SYNDROME; PYELORENAL BACKFLOW; FLUID ABSORPTION; PELVIC PRESSURE; METABOLIC-CHANGES; NEPHROLITHOTOMY; FLOW; ELECTROLYTE;
D O I
10.1007/s00345-018-2378-4
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
PurposeTo perform a review on the latest evidence related to normal and pathological intrarenal pressures (IRPs), complications of incremented values, and IRP ranges during endourology.MethodsA literature search was performed using PubMed, restricted to original English-written articles, including animal, artificial model, and human studies. Different keywords were: percutaneous nephrolithotomy, PCNL, ureteroscopy, URS, RIRS, irrigation flow, irrigation pressure, intrarenal pressure, intrapelvic pressure and renal pelvic pressure.ResultsNormal IRPs range from zero to a few cm H2O. Pyelovenous backflow may occur at pressure range of 13.6-27.2cm H2O. During upper tract endourology, complications such as pyelorenal backflow, sepsis, and renal damage are directly related to increased IRPs. Duration of increased IRPs and concomitant obstruction are independent predictors of complication development.ConclusionsIRP increase remains a neglected predictor of upper tract endourology complications and its intraoperative monitoring should be taken into consideration. Further research is necessary, to quantify pressures generated during upper tract endourology, and introduce means of controlling them.
引用
收藏
页码:125 / 131
页数:7
相关论文
共 59 条
[1]   Hormonal and hemodynamic changes during percutaneous nephrolithotomy [J].
Atici Ş. ;
Zeren S. ;
Ariboǧan A. .
International Urology and Nephrology, 2001, 32 (3) :311-314
[2]   INTRA-RENAL REFLUX [J].
BOCCAFOSCHI, C ;
LUGNANI, F .
UROLOGICAL RESEARCH, 1985, 13 (05) :253-258
[3]   IRRIGATION AND ACUTE URETERIC DILATATION - AS FOR URETEROSCOPY [J].
BODDY, SAM ;
NIMMON, CC ;
JONES, S ;
RAMSAY, JWA ;
BRITTON, KE ;
LEVISON, DA ;
WHITFIELD, HN .
BRITISH JOURNAL OF UROLOGY, 1989, 63 (01) :11-13
[4]   THE BIOMECHANICAL PRINCIPLES OF UPPER URINARY-TRACT PRESSURE-FLOW STUDIES [J].
BULLOCK, KN .
BRITISH JOURNAL OF UROLOGY, 1983, 55 (02) :136-139
[5]   Oxidative Damage and Mitochondrial Injuries Are Induced by Various Irrigation Pressures in Rabbit Models of Mild and Severe Hydronephrosis [J].
Cao, Zhixiu ;
Yu, Weimin ;
Li, Wei ;
Cheng, Fan ;
Rao, Ting ;
Yao, Xiaobing ;
Zhang, Xiaobin ;
Larre, Stephane .
PLOS ONE, 2015, 10 (06)
[6]   Acute Kidney Injuries Induced by Various Irrigation Pressures in Rat Models of Mild and Severe Hydronephrosis [J].
Cao, Zhixiu ;
Yu, Weimin ;
Li, Wei ;
Cheng, Fan ;
Xia, Yue ;
Rao, Ting ;
Yao, Xiaobing ;
Zhang, Xiaobin ;
Larre, Stephane .
UROLOGY, 2013, 82 (06) :1453.e9-1453.e16
[7]   PERITONEAL EXTRAVASATION DURING PERCUTANEOUS LITHOTRIPSY [J].
CARSON, CC ;
NESBITT, JA .
JOURNAL OF UROLOGY, 1985, 134 (04) :725-727
[8]   Long-term endoscopic management of upper tract urothelial carcinoma: 20-year single-centre experience [J].
Cutress, Mark L. ;
Stewart, Grant D. ;
Wells-Cole, Simon ;
Phipps, Simon ;
Thomas, Ben G. ;
Tolley, David A. .
BJU INTERNATIONAL, 2012, 110 (11) :1608-1617
[9]  
Cybulski P, 2004, J ENDOUROL, V18, P739, DOI 10.1089/end.2004.18.739
[10]   ABSORPTION OF IRRIGATING FLUID DURING PERCUTANEOUS TRANSRENAL LITHOTRIPSY [J].
DIMBERG, M ;
NORLEN, H ;
HOGLUND, N ;
ALLGEN, LG .
SCANDINAVIAN JOURNAL OF UROLOGY AND NEPHROLOGY, 1993, 27 (04) :463-467