Analysis Of Risk Factors For Spontaneous Rupture Of Renal In Patients With Hydronephrosis

Objective: To explore the risk factors of spontaneous rupture of kidney in patients with hydronephrosis,it has important clinical significance for the prevention and treatment of this disease.Methods: Collection of medical records of 85 patients with hydronephrosis complicated with spontaneous renal rupture from January 2010 to December 2018 in the Department of Urology,Affiliated Hospital of Zunyi University(age,sex,urine white blood cells,urinary red blood cells,urine PH,urinary protein,urinary bacterial culture,albumin,serum creatinine,size and position of kidney stones and ureteral stones,ureterostegnosis,renal tuberculosis,pyelonephritis,thickness of renal parenchyma,kidney length Diameter,renal pelvis urine CT value and hydronephrosis degree,named as renal rupture group.According to the ratio of 1:3,the medical records of 255 patients with hydronephrosis without renal rupture in the same interval were randomly selected as the control group.The 80% case group and 80% control group were randomly selected as the training set.Multivariate logistic regression was used to determine the influencing factors of spontaneous rupture of kidney in patients with hydronephrosis.Then multivariate logistic regression was used to establish a predictive model of spontaneous renal rupture of hydronephrosis.The area under the ROC curve was calculated.The remaining 20% case group and 20% control group were used as test sets to evaluate the authenticity and reliability of the model.Results: Univariate analysis screened 14 factors associated with spontaneous renal rupture of hydronephrosis,including hydronephrosis,parenchymal thickness,and renal pelvis urine CT values.Multivariate logistic regression analysis showed that severe hydronephrosis,high renal pelvis urine CT value,ureteral calculi,ureteral stricture and urinary microbial culture positive were risk factors for renal rupture of hydronephrosis,and renal parenchyma thick and high plasma levels albumin were protective factors for spontaneous renal rupture of hydronephrosis.The logistic regression model was established.The area under the ROC curve was 0.802(95% CI: 0.689~0.915),the sensitivity and specificity were 70.6% and 80.4%,the Yoden index was 53.0%,and the kappa value was 0.491.Between 0.41~0.60).Conclusions: 1.Severe hydronephrosis,high renal pelvis urine CT value,ureteral calculi,ureteral stricture,and intrarenal infection are risk factors for spontaneous renal rupture in hydronephrosis.2.This study provides a reference for the intervention of hydronephrosis and early warning of spontaneous renal rupture.