Retrospective evaluation of retroperitoneal fibrosis patients for epidemiology and treatment

Retroperitoneal Fibrosis is a disease in which fibrotic and inflammatory tissue usually surrounds the vascular and urinary tract in the retroperitoneum and can cause renal failure It is about 3 times that of women in men. The average age at diagnosis is 50-60 years. Surgical and medical treatment is used. The most important problems are that the majority of the etiology is uncertain, the symptoms and signs are not specific, they are confused with many tables in differential diagnosis, and there is no generalizable treatment regimen. To present the experience of the disease features of our center; we aimed to make standardization recommendations on the treatment regimen and its definitions and to establish a regional and national example. Between November 2000 and June 2020, the files of 35 patients who were followed up with the diagnosis of Retroperitoneal Fibrosis at Uludağ University Medical Faculty Hospital were retrospectively reviewed. Epidemiological, admission symptoms and findings, laboratory values, coomorbidities, diagnostic tools, imaging features, treatments and follow-up times were investigated. Patients were divided into groups with 'Full', 'Partial', 'Inadequate' responses created with serology, symptoms and findings, mass size reduction parameters to standardize treatment regimen and response to treatment. In the analysis, 'Full Response' and 'Partial and Inadequate Response' groups were compared and analyzed. In our study, the mean age of diagnosis was 50-60 years, approximately 3 times the diagnosis in men and 91% idiopathic etiology. The admission laboratory, symptoms, and findings were similar to the literature. On imaging findings, ureter compression was 74%, vascular pressure 45%, and thrombosis 28.5%. In our study, in which steroid and azathioprine are among the most commonly used medical treatments, a significant difference was observed between the response groups in the initial treatment regimen (p: 0.037). In the treatment regimen subgroup analysis, although the number of patients was insufficient, it was observed that 6 out of 7 patients with complete response initially received combination therapy. It was thought that this ratio in complete responses was effective in the significant difference in the analysis. In conclusion, although it is recommended to focus on the combination regimen in the initial treatment, larger studies are needed to evaluate the etiology, duration of treatment, response and treatment regimen. Keywords: Retroperitoneal Fibrosis, Initial Therapy, Idiopathic