Etiogenesis and renal outcome of adult patients with obstructive uropathy in South-East Asia. A tertiary hospital based prospective study

Abstract

Background: Obstructive uropathy is a condition in which urinary flow is impeded, leading to kidney impairment, and it continues to be a major cause of renal disease in Southeast Asian populations. Multiple factors contribute to its development, including metabolic abnormalities, structural obstructions, infections, and tumors. Aim: To determine the etiological spectrum and clinical profile of adult patients with obstructive uropathy in a tertiary hospital in North India, and to evaluate the relative frequency of causative factors contributing to renal impairment. Although international research identifies kidney stones and prostate enlargement as the main causes, regional information is scarce because of differences in diet, environment, and healthcare access. Materials and Methods: A hospital-based prospective study was conducted from August 2022 to July 2024 at Jawaharlal Nehru Medical College, Aligarh. A total of 106 patients with obstructive uropathy were evaluated through clinical, biochemical, and imaging assessments. Following exclusion of 36 patients with lower tract obstruction and 2 with bilateral interventions, 68 patients with upper urinary tract obstruction were included. Patients underwent percutaneous nephrostomy (PCN) or double J (DJ) stenting and were followed up for renal recovery at 1 and 3 months. Data were analyzed using Chi-square tests for statistical significance. Results: Nephrolithiasis with hydronephrosis (31.1%), bladder outlet obstruction due to prostatomegaly (30.2%), and ureteric calculus with hydroureteronephrosis (20.8%) were the leading etiologies. Collectively, stone-related disorders constituted 57.5% of cases, while bladder outlet obstruction accounted for 33.0%. Malignancies and infections such as pyonephrosis were less frequent (2.8%-5.7%). Statistical analysis (χ² = 188.339, p