RENAL-FUNCTION IN JAUNDICED PATIENTS - A PROSPECTIVE ANALYSIS

A prospective analysis was undertaken to assess renal function in pati ents with obstructive jaundice. A total of 59 jaundiced patients (seru m bilirubin >100 mu mol/l) undergoing biliary decompression by surgica l, endoscopic or radiological means received prophylactic fluid volume expansion (3 litres crystalloid fluid intravenously) during the 24 ho urs before intervention. Renal function (urea and electrolytes, creati nine, creatinine clearance, urinary output) was assessed preoperativel y and on days 1-7 and on day 28 postoperatively. Two jaundiced patient s (3.4%) developed renal failure (urinary output <400 ml in 24 hours i n the presence of an increased serum urea and/or creatinine) and subse quently died. The overall incidence of post-procedural renal impairmen t (urinary output <800 ml in 24 hours) was 10.2%, It is concluded that , with vigilant control of fluid and electrolyte balance and pre-proce dural intravenous volume expansion, the incidence of renal dysfunction in patients with obstructive jaundice is not as high as previously re ported.