<![CDATA[Background: Hydronephrosis may impair renal function and contribute to hypertension, particularly when obstruction is severe or bilateral. This study evaluated the associations of hydronephrosis severity and laterality with serum creatinine and blood pressure among adults.Methods: A retrospective analytic observational study was conducted using medical records of 87 adults with hydronephrosis who underwent abdominal computed tomography at Royal Prima Medan Hospital, North Sumatra, Indonesia. Hydronephrosis was classified from Grade 1 to Grade 4, and obstruction was categorized as unilateral or bilateral. Multiple linear regression models assessed independent predictors of serum creatinine, systolic blood pressure, and diastolic blood pressure after adjustment for age and sex.Results: The mean participant age was 53.2 ± 14.8 years. Bilateral hydronephrosis was present in 29.9% of participants, while Grade 4 hydronephrosis occurred in 21.8%. Bilateral obstruction was independently associated with higher serum creatinine (B = 1.280 mg/dL; p < 0.001), systolic blood pressure (B = 6.850 mmHg; p = 0.021), and diastolic blood pressure (B = 4.120 mmHg; p = 0.038). Grade 4 hydronephrosis was also associated with increased serum creatinine (B = 1.911 mg/dL; p < 0.001), systolic blood pressure (B = 16.820 mmHg; p < 0.001), and diastolic blood pressure (B = 8.940 mmHg; p = 0.004). Age independently predicted systolic blood pressure (B = 0.521 mmHg/year; p < 0.001).Conclusion: Bilateral obstruction and severe hydronephrosis were important independent predictors of renal dysfunction and elevated blood pressure. These patients may benefit from closer renal-function and blood-pressure monitoring and timely urological assessment.]]>
