Long-term renal dysfunction in patients with acute urinary retention

Objective: Acute urinary retention (AUR) causes bilateral renal obstruction , which has been found to affect kidney function. This study evaluated both glomerular and tubular renal function in the long term after the resolutio n of AUR. Material and methods: Renal function in 15 patients affected by A UR and found still to evince renal dysfunction 6 months afterwards was re e valuated approximately 18 months after the episode. The bladder outlet obst ruction was treated and all patients voided normally at 6 month control. Re sults: The percentage of patients suffering from lowered creatinine clearan ce and elevated alpha (1)-microglobulin excretion increased during follow-u p from AUR up to 6 and 18 months (46% to 57% to 79% and 42% to 71% to 100%, respectively). In addition, daily protein excretion was abnormally high in 69% of patients at the 18 month follow-up. In most cases the abnormalities found in renal function were mild. Conclusion: Patients evincing renal dys function 6 months after AUR showed permanent impairment in tubular function , whereas glomerular permeability had partially recovered. Although this ma y be explained in part by chronic obstruction prior to AUR and although the impairment was mild in most cases, these findings stress the importance of urgent treatment of AUR to avoid the development of renal failure.