Advertisement

Obstructive Uropathy in Critically Ill Cancer Patients

  • Chukwuma O. Kalu
  • Ala AbudyayehEmail author
Living reference work entry

Abstract

A range of retroperitoneal, metastatic, and pelvic malignancies cause urinary tract obstruction via direct spread or extrinsic compression of the urinary tract, particularly the ureters. Urinary tract obstruction, secondary to malignancy, poses a myriad of challenges to the health practitioner due to significant morbidities arising from acute kidney injury and end-stage renal disease. There is a crucial need to alleviate acute symptoms and preserve renal function via catheterization, stents, or surgery while addressing the primary disease. This chapter provides an available up to date data on this oncologic emergency and its management.

Keywords

Urinary tract obstruction Obstructive uropathy BK virus Retroperitoneal fibrosis Bladder outlet obstruction Percutaneous nephropathy Hydronephrosis Acute kidney injury 

References

  1. 1.
    Arthur RR, Shah KV, Baust SJ, et al. Association of BK viruria with hemorrhagic cystitis in recipients of bone marrow transplants. N Engl J Med. 1986;315(4): 230–4.CrossRefGoogle Scholar
  2. 2.
    Batlle DC, Arruda JA, Kurtzman NA. Hyperkalemic distal renal tubular acidosis associated with obstructive uropathy. N Engl J Med. 1981;304(7):373–80.CrossRefGoogle Scholar
  3. 3.
    Bedi A, Miller CB, Hanson JL, et al. Association of BK virus with failure of prophylaxis against hemorrhagic cystitis following bone marrow transplantation. J Clin Oncol. 1995;13(5):1103–9.CrossRefGoogle Scholar
  4. 4.
    Brien JC, Shariat SF, Herman MP, et al. Preoperative hydronephrosis, ureteroscopic biopsy grade and urinary cytology can improve prediction of advanced upper tract urothelial carcinoma. J Urol. 2010;184(1): 69–73.CrossRefGoogle Scholar
  5. 5.
    Cho KS, Hong SJ, Cho NH, et al. Grade of hydronephrosis and tumor diameter as preoperative prognostic factors in ureteral transitional cell carcinoma. Urology. 2007;70(4):662–6.CrossRefGoogle Scholar
  6. 6.
    Geddes CC, Gunson R, Mazonakis E, et al. BK viremia surveillance after kidney transplant: single-center experience during a change from cyclosporine-to lower-dose tacrolimus-based primary immunosuppression regimen. Transplant Infect Dis. 2011;13(2): 109–16.CrossRefGoogle Scholar
  7. 7.
    Harkensee C, Vasdev N, Gennery AR, et al. Prevention and management of BK-virus associated haemorrhagic cystitis in children following haematopoietic stem cell transplantation–a systematic review and evidence-based guidance for clinical management. Br J Haematol. 2008;142(5):717–31.CrossRefGoogle Scholar
  8. 8.
    Hwang SJ, Haas M, Harris HW Jr, et al. Transport defects of rabbit medullary thick ascending limb cells in obstructive nephropathy. J Clin Invest. 1993;91(1): 21–8.CrossRefGoogle Scholar
  9. 9.
    Ito Y, Kikuchi E, Tanaka N, et al. Preoperative hydronephrosis grade independently predicts worse pathological outcomes in patients undergoing nephroureterectomy for upper tract urothelial carcinoma. J Urol. 2011;185(5):1621–6.CrossRefGoogle Scholar
  10. 10.
    Khan H, Oberoi S, Mahvash A, et al. Reversible ureteral obstruction due to polyomavirus infection after percutaneous nephrostomy catheter placement. Biol Blood Marrow Transplant. 2011;17(10):1551–5.CrossRefGoogle Scholar
  11. 11.
    Klahr S. New insights into the consequences and mechanisms of renal impairment in obstructive nephropathy. Am J Kidney Dis. 1991;18(6):689–99.CrossRefGoogle Scholar
  12. 12.
    Kocurek JN, Orihuela E, Saltzstein DR. Nondilated obstructive uropathy and renal failure as a result of carcinoma of the intrapelvic area. Surg Gynecol Obstet. 1991;173(6):470–2.PubMedGoogle Scholar
  13. 13.
    Kouba E, Wallen EM, Pruthi RS. Management of ureteral obstruction due to advanced malignancy: optimizing therapeutic and palliative outcomes. J Urol. 2008;180(2):444–50.CrossRefGoogle Scholar
  14. 14.
    Madsen MG, Nørregaard R, Frøkiær J, et al. Urinary biomarkers in prenatally diagnosed unilateral hydronephrosis. J Pediatr Urol. 2011;7(2):105–12.CrossRefGoogle Scholar
  15. 15.
    Mcinnes EG, Levy DW, Chaudhuri MD, et al. Renal failure in the elderly. Q J Med. 1987;64(243):583.PubMedGoogle Scholar
  16. 16.
    Ng CK, Shariat SF, Lucas SM, et al. Does the presence of hydronephrosis on preoperative axial CT imaging predict worse outcomes for patients undergoing nephroureterectomy for upper-tract urothelial carcinoma. Urol Oncol. 2011;29(1):27–32.CrossRefGoogle Scholar
  17. 17.
    Pahari A, Rees L. BK virus-associated renal problems–clinical implications. Pediatr Nephrol (Berlin, Germany). 2003;18(8):743–8.CrossRefGoogle Scholar
  18. 18.
    Pradhan TS, Duan H, Katsoulakis E, et al. Hydronephrosis as a prognostic indicator of survival in advanced cervix cancer. Int J Gynecol Cancer. 2011;21(6):1091–6.CrossRefGoogle Scholar
  19. 19.
    Rademakers K, Drake MJ, Gammie A, et al. Male bladder outlet obstruction: time to re-evaluate the definition and reconsider our diagnostic pathway? ICI-RS 2015. Neurourol Urodyn. 2017;36(4):894–901.CrossRefGoogle Scholar
  20. 20.
    Savva-Bordalo J, Pinho Vaz C, Sousa M, et al. Clinical effectiveness of hyperbaric oxygen therapy for BK-virus-associated hemorrhagic cystitis after allogeneic bone marrow transplantation. Bone Marrow Transplant. 2012;47(8):1095–8.CrossRefGoogle Scholar
  21. 21.
    Schreiner GF, Kohan DE. Regulation of renal transport processes and hemodynamics by macrophages and lymphocytes. Am J Phys. 1990;258(4 Pt 2):F761–7.Google Scholar
  22. 22.
    Soper JT, Blaszczyk TM, Oke E, et al. Percutaneous nephrostomy in gynecologic oncology patients. Am J Obstet Gynecol. 1988;158(5):1126–31.CrossRefGoogle Scholar
  23. 23.
    Spital A, Spataro R. Nondilated obstructive uropathy due to a ureteral calculus. Am J Med. 1995;98(5): 509–11.CrossRefGoogle Scholar
  24. 24.
    Tanner GA, Knopp LC. Glomerular blood flow after single nephron obstruction in the rat kidney. Am J Phys. 1986;250(1 Pt 2):F77–85.Google Scholar
  25. 25.
    Tseng TY, Stoller ML. Obstructive uropathy. Clin Geriatr Med. 2009;25(3):437–43.CrossRefGoogle Scholar
  26. 26.
    Vaglio A, Salvarani C, Buzio C. Retroperitoneal fibrosis. Lancet. 2006;367(9506):241–51.CrossRefGoogle Scholar
  27. 27.
    Webb JA. Ultrasonography in the diagnosis of renal obstruction. BMJ. 1990;301(6758):944–6.CrossRefGoogle Scholar
  28. 28.
    Wong LM, Cleeve LK, Milner AD, et al. Malignant ureteral obstruction: outcomes after intervention. Have things changed? J Urol. 2007;178(1): 178–83;Discussion 183CrossRefGoogle Scholar
  29. 29.
    Zeisberg M, Neilson EG. Mechanisms of tubulointerstitial fibrosis. J Am Soc Nephrol. 2010;21(11): 1819–34.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.UTHealth and MD Anderson Cancer CenterHoustonUSA
  2. 2.Division of Internal Medicine, Section of NephrologyThe University of Texas MD Anderson Cancer CenterHoustonUSA

Personalised recommendations