Renal failure due to unilateral ureteral obstruction. A scoping review
DOI:
https://doi.org/10.18041/2665-427X/ijeph.2.8237Keywords:
Unilateral ureteral obstruction, acute renal failure, chronic renal failure, apoptosis, renal fibrosisAbstract
Introduction: In patients with unilateral ureteral
obstruction, around 1-10% develop acute renal failure. Its
low incidence is due to creatinine levels that are generally
normal because the contralateral kidney maintains its
functional excretory capacity intact.
Objective: To describe in a broad and specific way all
the physiopathological processes that are involved in
unilateral ureteral obstruction which leads to acute and/
or chronic renal failure.
Methods: Was used PRISMAP, ScR extension for scope
reviews for the analysis and structuring of the article.
The search was performed in PubMed, Medline and
Embase and with articles dealing with renal failure due to
unilateral ureteral obstruction. The review of the articles
was done by two reviewers independently.
Results: Once the articles that did not comply were
evaluated and excluded, 16 references were analyzed.
The physiopathological mechanisms are described
considering the evolution time of the obstructed
kidney. Finally, some possible causes of renal failure
are considered in patients with unilateral ureteral
obstruction who have another completely healthy
kidney. As a hypothesis there are two crucial events that
cause renal failure in unilateral ureteral obstruction.
A) Decrease in renal blood flow given the production
of ANGII and its impact on vascular smooth muscle,
decreasing the glomerular filtration rate (GFR) and
B) perirenal extravasation of urine and its role in the
elevation of creatinine.
Conclusions: The understanding of this process allows to
expand the knowledge regarding the mechanism of the
damage, the time in which it occurs and its progression.
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