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How is Dietl’s Crisis linked to renal function?

01 Oct 2020

Dietl’s Crisis may manifest at an earlier age in children with prenatally detected hydronephrosis, a recent study has found. The duration of the Dietl’s Crisis attack and anteroposterior diameter (APD) appear to be correlates of impaired differential renal function (DRF).

Using a DRF cut-off value of 40 percent, researchers divided the 143 enrolled participants (age at first onset, 5.53±2.63 years; 84.67 percent male) into two: DRF ≥40 percent and <40 percent. All included patients had undergone unilateral dismembered pyeloplasty and had at least one episode of Dietl’s Crisis before the operation.

The average DRF before surgery was 41.03±10.59 percent, and this was nominally higher in those with vs without prenatal hydronephrosis (41.37±10.63 percent vs 40.58±10.98 percent; p=0.692). Moreover, those whose hydronephrosis was detected prenatally developed Dietl’s Crisis significantly earlier (4.58 vs 5.87 years; p=0.002).

The duration of the pain of a single Crisis attack ranged from 10 minutes to 72 hours, with a median value of 2 hours. However, Wilcoxon’s rank sum test found that children who had DRF <40 percent experienced significantly longer attacks than their counterparts with DRF ≥40 percent (4 vs 2 hours; p=0.032).

The average maximum and minimum APD were 37.27±12.92 and 17.44±6.97 mm, respectively. Maximum APD was measured during or right after a Crisis attack, when the pain was still present, and the minimum was measured when pain had completely resolved. Researchers found that patients with DRF <40 percent had significantly greater peak APD (p=0.001).

Multivariate logistic regression analysis confirmed that maximum APD (p=0.018) and the duration of a Dietl’s Crisis attack (p=0.023) were significantly associated with DRF <40 percent.

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Most Read Articles
Jairia Dela Cruz, 05 Oct 2020
Drinking more than two cups of coffee per day may just be the intervention that prevents hundreds of thousands of liver disease‐related deaths globally, a study reports.
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