Peer-review started: August 31, 2022
First decision: September 27, 2022
Revised: October 27, 2022
Accepted: December 21, 2022
Article in press: December 21, 2022
Published online: January 25, 2023
Processing time: 131 Days and 4.3 Hours
Obstructive uropathy is an important cause of acute and chronic kidney disease. Decompression of the urinary tract is an essential aspect of treatment. The cause and aetiology of obstruction typically determine the surgical approach. Acute relief of obstruction is frequently complicated by fluid and electrolyte imbalance. Standard therapeutic interventions for acute or chronic renal failure also apply for cases of obstructive uropathy. This narrative review summarises the early and long-term medical management of obstructive uropathy.
Core Tip: Obstructive uropathy is a prevalent cause of acute and chronic kidney disease. Urinary tract decompression is the single most beneficial aspect of management; renal impairment is frequently reversible and the long-term renal prognosis is generally excellent. Subsequent medical care is an important but underappreciated supplement to surgical treatment. Acute relief of obstruction is often complicated by disorders of sodium and potassium balance and post-obstructive diuresis. Longer-term management principles are similar to those for other forms of chronic kidney disease.