Dr Padillo and colleagues evaluated the factors determining preoperative renal dysfunction in patients with obstructive jaundice.
The investigators conducted a prospective cross-sectional observational study.
The investigative team assessed 63 patients, of which 27 had benign and 36 had malignant obstructive jaundice at admission.
The patients were compared with 25 healthy control subjects.
The team analyzed variables including extracellular body water compartment, and plasma levels of aldosterone.
|54% of patients had a creatinine clearance of less than 70 ml/min |
|British Journal of Surgery|
Renin, atrial natriuretic peptide, vasopressin, nitric oxide, endothelin 1 and prostaglandin E2 were also assessed.
In addition, the team analyzed urinary nitric oxide and prostaglandin E2, serum albumin and renal function.
The team noted that the metabolic profile of obstructive jaundice was characterized by a depletion of the extracellular body water.
Increased plasma levels of atrial natriuretic peptide, endothelin 1, vasopressin, aldosterone and renin characterized the metabolic profile.
Increased plasma and urinary prostaglandin E2 levels were also found.
The investigators observed that 54% of patients had a creatinine clearance of less than 70 ml/min.
In multivariate analysis, serum bilirubin, renin, and endothelin 1 were identified as predictors of renal dysfunction.
The team also identified prostaglandin E2, decreased urinary sodium excretion and age were identified as predictors of renal dysfunction.
Dr Padillo's team commented, “Renal dysfunction in patients with obstructive jaundice was associated with the degree of biliary obstruction, age of the patient and reduced urinary sodium excretion.”
“These alterations were closely related to derangements in sodium- and water-regulating hormones.”