dc.contributor.author |
Kimutai, Nicholas Kimeto |
|
dc.date.accessioned |
2021-11-03T06:15:57Z |
|
dc.date.available |
2021-11-03T06:15:57Z |
|
dc.date.issued |
2021 |
|
dc.identifier.uri |
http://ir.mu.ac.ke:8080/jspui/handle/123456789/5351 |
|
dc.description.abstract |
Background: Percutaneous nephrostomy (PCN) is an interventional radiology
procedure whereby a flexible catheter is placed in the renal pelvis through the skin
using image guidance. PCN is commonly performed for various benign and malignant
indications and affords immediate decompression of the obstructed renal collecting
system but can also be done for temporary urinary diversion in indications like
urinary fistula, ureteric leaks and haemorrhagic cystitis. Laboratory, clinical and
radiological outcomes post PCN placement are variable and influenced by several
factors such as duration and extent of obstruction and status of contralateral kidney.
Objective: To describe the indications, clinical, radiological and laboratory outcomes
and complications of PCN at Moi Teaching and Referral Hospital, Eldoret Kenya.
Methods: A prospective study was conducted on all 68 patients undergoing
ultrasound guided PCN between June 2019 to May 2020.A census methodology was
used. All patients who met the eligibility criteria and gave informed consent were
enrolled in the study. Data collection form was used to record demographic and
clinical data, renal ultrasonographic findings and laboratory investigations results, as
well as complications. Data analysis done using SPSS software. Continuous variables
were summarized using means and standard deviations, median and inter-quartile
ranges (IQR) while categorical variables were summarized using frequencies and
percentages. McNemar’s test was used to determine the differences in proportion in
categorical data pre and post PCN while Wilcoxon Ranked test was used to determine
differences pre and post PCN for continuous variables. All P values were two-sided at
a 0.05 significance level.
Results: PCN placement was successful in all the 68 patients. The mean age of the 68
patients included in the study was 37.62 ±12.5. (SD) years. A total of 38 (55.9%) of
the patients were female. Malignancy was the most common indication for PCN n=55
(80.8%). Inflammatory indications and calculi were the second most common
indications each constituting 4(5.8%). Cancer of the cervix was the commonest
malignancy (32.7%) followed by prostate cancer. There was clinical improvement
with reduction in degree and number of patients with oedema and flank pains 2
weeks post PCN.1(8.3%) patient discontinued dialysis two weeks post PCN. There
was significant reduction in Urea, Creatinine and Potassium levels post PCN (Pvalue<
0.05). The study found a statistically significant increase in renal cortical
thickness post PCN. There was no statistically significant change in parenchymal
echogenicity and corticomedullary differentiation post PCN.15(22%) of the
participants developed complications after PCN, of which major were 5(7.5%) and
minor complications 10(14.5%).No deaths resulted from the procedure.
Conclusion: Malignancy was the main indication for PCN in this study. PCN was
associated with improved clinical and laboratory outcomes. Majority of the patients
did not have any complications post PCN with most of the complications being minor |
en_US |
dc.description.sponsorship |
Ministry of Health and West Pokot County Government |
en_US |
dc.language.iso |
en |
en_US |
dc.publisher |
Moi University |
en_US |
dc.subject |
Indications |
en_US |
dc.subject |
Outcomes and complications |
en_US |
dc.subject |
Percutaneous nephrostomy |
en_US |
dc.subject |
Hydronephrosis |
en_US |
dc.title |
Indications, outcomes and complications of percutaneous nephrostomy at Moi Teaching and Referral Hospital, Eldoret, Kenya |
en_US |
dc.type |
Thesis |
en_US |