Upper urinary tract disease can result in permanent impairment that can be quantified using the AMA criteria.
Organs involved:
(1) kidneys
(2) ureters
Parameters:
(1) signs and symptoms
(2) need for therapy and its effectiveness
(3) function
(4) creatinine clearance
Signs and symptoms of an upper urinary tract disorder:
(1) costovertebral pain
(2) chills, fever
(3) hematuria
(4) edema
(5) impaired stamina
(6) change in urine volume (polyuria, oliguria, anuria)
(7) dry, dusky skin
(8) weight loss
|
Signs and Symptoms |
Treatment |
Function |
Creatinine Clearance |
Impairment of the Whole Person |
|
none |
none |
normal |
> 62.5 mL/min |
0% |
|
mild and intermittent |
intermittent |
only 1 kidney functioning |
52 – 62.5 mL/min |
0 - 14% |
|
moderate |
frequent with constant surveillance |
improves after renal transplant |
42 – 52 mL/min |
15 – 34% |
|
moderate |
continuous therapy partially ineffective |
|
28 – 42 mL/min |
35 – 59% |
|
severe |
ineffective |
requires peritoneal or hemodialysis |
< 28 mL/min |
60 – 95% |
where:
• Complications from therapy are graded separately then combined for the final whole person impairment. This includes endocrine or infectious complications of steroid therapy.
• I would think that loss of both kidneys would place the person in 60-95% whole person impairment.
If urinary diversion is required, then following impairment needs to be combined with the impairment from the upper urinary tract disease.
|
Urinary Diversion |
Impairment of the Whole Person |
|
ureterointestinal diversion |
10% |
|
cutaneous ureterostomy |
10% |
|
nephrostomy |
15% |
Specialty: Sports Medicine & Rehabilitation, Urology
