الفهرس 
AcknowledgementOnly 14 pages are availabe for public view
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Abstract
Po-AKI, as BOKs or obstructed solitary kidney, is not uncommon surgical emergency which has high rates of morbidity and mortality warranting urgent intervention and drainage of BOKs. Drainage of the kidney is done commonly by PCN or JJ helping patients avoid the inconveniences of dialysis. So, the predictors of recoverability of renal function has been studied thoroughly by many researchers to determine which patient according to their manifestations, imaging characteristics, and laboratory investigations benefits from the drainage and which modality of drainage would achieve that. However, there is no consensus on the optimal mode of drainage with the different underlying causes of BOKs.We conducted this prospective study that studied patients with BOKs presented to Assiut Urology and Nephrology Hospital, Assiut University during December 2019 – November 2021. The primary outcome was reaching a SCr nadir within 2 weeks from the drainage of BOKs. Routine physical evaluation and laboratory investigations were performed. Relevant demographic and clinical variables were studied relative to the primary outcome. This differentiated patients 2 groups; The Improved group who reached a normal SCr level or reched to nadir SCr (lowest SCr with 2 consecutive readings) and the Not-improved group who failed to reach a normal or nadir SCr The current results were from 107 patients with BOKs. After drainage of BOKs, 86 (80.4%) patients improved (Improved group), while 21 (19.6%) patients failed to regain a normal SCr or reach a nadir SCr level higher than the normal value (Not-improved group). There were no significant differences between the both groups in the studied variables, except the male gender (p=0.01), old age (p<0.001), MUO (p=0.01), unilateral drainage (p<0.001), and use of PCN for drainage (p<0.001) as predictors of non-improvement. By multivariate analysis, however, the only two independent predictors of non-improvement in patients with BOKs were the unilateral drainage (p=0.01) and MUO (p<0.001). Also time to reach nadir SCr in cases of benign obstruction was significantly shorter in bilateral drainage (P= 0.02) In conclusion, there were numerous modes of drainage of BOKs, when we considered the choice of the type of catheter and the laterality of drainage. The univariate analyses showed that the predictive factors for non-improvement of renal function represented by SCr level after drainage of BOKs included the male gender, old age, MUO, unilateral drainage, and use of PCN for drainage. By multivariate analysis, however, the only two independent predictors of non-improvement in patients with BOKs were the unilateral drainage and MUO. Bilateral drainage of BOKs was superior to unilateral drainage, regarding recoverability of renal function as represented by reduction of SCr level to a nadir.