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Deprecated: Implicit conversion from float 231.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Int+Neurourol+J 2017 ; 21 (2): 128-32 Nephropedia Template TP
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The Risk of Upper Urinary Tract Involvement in Patients With Ketamine-Associated Uropathy #MMPMID28673061
Yee CH; Teoh JYC; Lai PT; Leung VYF; Chu WCW; Lee Wm; Tam YH; Ng CF
Int Neurourol J 2017[Jun]; 21 (2): 128-32 PMID28673061show ga
Purpose: The aims of this study were to investigate the prevalence of upper tract involvement in ketamine-associated uropathy, and to determine the predictors of hydronephrosis in patients with a history of ketamine abuse. Methods: This was a cross-sectional study of a prospective cohort of patients with ketamine-associated uropathy. Data including demographics, pattern of ketamine abuse, pelvic pain and urgency or frequency (PUF) symptom score, uroflowmetry (UFM) parameters, serum renal function, and liver function tests were collected. Upon consultation, ultrasonography was performed to assess the function of the urinary system. Results: From December 2011 to October 2015, we treated 572 patients with ketamine-associated uropathy. Of these patients, 207 (36.2%) had managed to achieve abstinence at the time of their first consultation. Ninety-six patients (16.8%) in the cohort were found to have hydronephrosis on ultrasonography. Univariate analysis identified age, duration of ketamine abuse, PUF symptom score, voided volume on UFM, serum creatinine levels >100 ?mol/L, and an abnormal serum liver enzyme profile as factors associated with hydronephrosis. Logistic regression revealed the following parameters to be statistically related to hydronephrosis: age (adjusted odds ratio [OR], 1.090; 95% confidence interval [CI], 1.020?1.166; P=0.012), functional bladder capacity (adjusted OR, 0.997; 95% CI, 0.995?0.999; P=0.029), serum creatinine >100 ?mol/L (adjusted OR, 3.107; 95% CI, 1.238?7.794; P=0.016, and an abnormal serum liver enzyme profile (adjusted OR, 1.967; 95% CI, 1.213?3.187; P=0.006). Conclusions: Ketamine-associated uropathy can involve the upper urinary tract. Patient demographics as well as investigations of UFM, renal function tests, and liver function tests may allow us to identify at-risk patients.