Management of obstructive nephropathy in a tertiary hospital in North West Nigeria: A five-year review|
Muhammad, A. Sadiq; Abdulwahab-Ahmed, Abdullahi; Agwu, Peter N.; Abdullahi, Khalid & Mungadi, Ismaila A.
Background: Obstructive nephropathy is managed initially with urinary diversion and
possibly haemodialysis before definitive therapy. This study was aimed at determining the
pattern of presentation, aetiology and management options of obstructive nephropathy in
Methods: This was a five-year retrospective study of the patients managed for obstructive
nephropathy at our facility from January 2011-December 2015. Data were collected via a pro
forma and analysed using SPSS version 20.0.
Results: There were 106 patients managed for obstructive nephropathy with a mean age of
48.3 ± 17. 4 years and age range of 4 months to 85 years. The male: female ratio was 10:1.
The most common causes of obstructive nephropathy were bladder cancer (49.1%), benign
prostatic hyperplasia (BPH, 22.6%), bilateral ureteric stone (5.7%) and bilateral
schistosomal lower ureteric obstruction (4.7%). Urethral or suprapubic catheterisation
(22.6%), nephrostomy (2.8%) and dialysis (10.4%) were the initial treatments.
Chemoradiation was done for the patients with bladder cancer and 17.9% of the patients
had operative interventions, which included ureteroneocystostomy, open prostatectomy or
transurethral resection of the prostate, and ureteroscopy + lithotripsy. Fifty-two patients
(49.1%) died while awaiting dialysis and four patients (3.8%) developed end-stage renal
Conclusions: Bladder carcinomas, BPH, ureteric obstruction are the commonest causes of
obstructive nephropathy in our practice. The initial treatment includes urinary diversion
and or dialysis before definitive treatment.
obstructive nephropathy; bladder cancer; acute kidney injury; chronic kidney injury; urinary diversion; dialysis