Role of Transurethral Resection of the Prostate (TURP) in Chronic Kidney Disease Patients With Obstructive Uropathy

Obstructive uropathy secondary to benign prostatic hyperplasia (BPH) is an important and potentially reversible cause of chronic kidney disease (CKD) in elderly men.Transurethral resection of the prostate (TURP) is the standard surgical treatment for bladder outlet obstruction; however, its safety and the extent of renal recovery offered by this procedure in patients with established CKD remain insufficiently described.Therefore, we evaluated renal functional outcomes and complications of TURP in men with CKD and obstructive uropathy.In this prospective observational study conducted in the Department of Urology of a tertiary teaching hospital in Jammu, India, we followed 50 consecutive men with CKD, according to the estimated glomerular filtration rate (eGFR) staging distribution method and Exclusion Criteria for other causes of CKD, who underwent bipolar TURP for three months.Serum creatinine, eGFR and post-void residual (PVR) urine volume were compared before and after surgery using the paired samples t-test, with mean paired differences, 95% confidence intervals (CIs) and effect sizes reported.All 50 patients completed follow-up with no missing outcome data.Mean serum creatinine fell from 2.40 ± 0.78 to 1.92 ± 0.67 mg/dL (mean change -0.48 mg/dL, 95% CI-0.58 to -0.38; Cohen's dz = 1.43), mean eGFR rose from 41.1 ± 12.1 to 52.1 ± 16.4 mL/min/1.73m² (+11.0,95% CI 6.9 to 15.1; dz = 0.76) and mean PVR fell from 241.0 ± 111.0 to 90.0 ± 69.0 mL (-151.0mL, 95% CI -179.5 to -122.5; dz = 1.51) (p < 0.001 for each).Renal function improved in 43 patients (86%, 95% CI 73.8-93.0%),remained stable in six (12%) and did not recover in one (2%).Complications occurred in 19 patients (38%, 95% CI 25.9-51.8%),all Clavien-Dindo grades I-II, with no mortality.TURP relieved bladder outlet obstruction and was associated with significant improvement in renal function in men with CKD stages 2-4, with an acceptable, predominantly minor complication profile.Timely intervention, before irreversible nephron loss, appears to be important for renal recovery.