Pressure Matters: Intrarenal Pressures During Normal and Pathological Conditions, and Impact of Increased Values to Renal Physiology

Overview

Journal World J Urol

Specialty Urology

Date 2018 Jun 20

PMID 29915945

Citations 84

Authors

Theodoros Tokas

Thomas R W Herrmann

Andreas Skolarikos

Udo Nagele

Affiliations

Soon will be listed here.

Abstract

Purpose: To perform a review on the latest evidence related to normal and pathological intrarenal pressures (IRPs), complications of incremented values, and IRP ranges during endourology.

Methods: A literature search was performed using PubMed, restricted to original English-written articles, including animal, artificial model, and human studies. Different keywords were: percutaneous nephrolithotomy, PCNL, ureteroscopy, URS, RIRS, irrigation flow, irrigation pressure, intrarenal pressure, intrapelvic pressure and renal pelvic pressure.

Results: Normal IRPs range from zero to a few cm HO. Pyelovenous backflow may occur at pressure range of 13.6-27.2 cm HO. During upper tract endourology, complications such as pyelorenal backflow, sepsis, and renal damage are directly related to increased IRPs. Duration of increased IRPs and concomitant obstruction are independent predictors of complication development.

Conclusions: IRP increase remains a neglected predictor of upper tract endourology complications and its intraoperative monitoring should be taken into consideration. Further research is necessary, to quantify pressures generated during upper tract endourology, and introduce means of controlling them.

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