Assessment of increase in renal pelvic size on post-void sonography as a predictor of vesicoureteral reflux

Evans, Elizabeth; Meyer, James S.; Harty, Michael; Bellah, Richard D.

doi:10.1007/s002470050591

Cited by 28 publications

(14 citation statements)

References 6 publications

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“…This prospective study has confirmed the hypothesis that fluctuation of the renal pelvis is associated with highgrade VUR, as others have suggested [9,10,11]. Highgrade VUR was persistent in those with fluctuation, necessitating surgery in the majority.…”

Section: Discussionsupporting

confidence: 88%

“…These sonographic signs include pelvic or ureteral wall thickening [2,6], calyceal or ureteral dilatation [2], pelvic dilatation [3,7], absence of corticomedullary differentiation [2,3], hyperechoic cortex or renal cysts [2,3], displacement of ureteric jet in the bladder [8], and intermittent dilatation and ballooning of the collecting system [9,10,11].…”

Section: Introductionmentioning

confidence: 98%

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Fluctuating fetal or neonatal renal pelvis: marker of high-grade vesicoureteral reflux

Anderson¹,

Allan

Abbott³

2004

Pediatric Nephrology

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Fetal renal pelvic dilatation is a predictor of vesicoureteral reflux (VUR), but has low specificity. The aim of this study was to determine the clinical significance of fluctuating size of the renal pelvis on sonography, particularly in relationship to VUR. We prospectively recorded fetal renal pelvic diameter >/=4 mm in 1,092 fetuses (692 boys), from May 1989 to December 1995, with a minimum follow-up of 7 years. Fluctuation, defined as size of renal pelvis changing by more than 4 mm during the course of obstetric (23), postnatal (128), and both pre- and postnatal (7) renal sonograms, was recorded prospectively in 159 (117 boys). Of the 1,092, 849 (593 boys) had a voiding cystourethrogram at a mean age of 7 weeks (range 3-20 weeks). Of the 31 (16 girls) with high-grade VUR, fluctuation was observed in 20 (9 girls). Fluctuation was strongly associated with high-grade VUR (odds ratio 11.1, P=0.0000003) and with renal damage (sensitivity 61%, positive predictive value 31%). Primary high-grade VUR was persistent, seen equally in boys and girls, and required surgery in the majority. Fluctuation was associated with renal duplication anomalies ( P=0.00009) and megaureter ( P<0.00000001). Fluctuation of the renal pelvis on sonography is a marker for persistent high-grade VUR and renal damage in girls and boys.

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Section: Discussionsupporting

confidence: 88%

Section: Introductionmentioning

confidence: 98%

Fluctuating fetal or neonatal renal pelvis: marker of high-grade vesicoureteral reflux

Anderson¹,

Allan

Abbott³

2004

Pediatric Nephrology

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“…Eleven studies evaluated standard 119,139,175,176,183,185,186,210,212,214 or duplex 142 ultrasound compared with the reference standard of MCUG. One study 185 reported data for a variety of cut-off points.…”

Section: Conventional Ultrasoundmentioning

confidence: 99%

Clinical effectiveness and cost-effectiveness of tests for the diagnosis and investigation of urinary tract infection in children: a systematic review and economic model

Whiting¹,

Westwood²,

Bojke³

et al. 2006

Health Technol Assess

133

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The results of the systematic review were used to derive an algorithm for the diagnosis of UTI in children under 5. This algorithm represents the conclusions of the review in terms of effective practice. There were insufficient data to propose an algorithm for the further investigation of UTI in children under 5. The quality assessment highlighted several areas that could be improved upon in future diagnostic accuracy studies.

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“…The renal size, however, was estimated by the examiners and not quantitatively recorded or compared to age-specific growth charts. Attempts have also been made to diagnose reflux by assessment of the diameter of the renal pelvis on US with a reported accuracy of over 90% [10,17], but these findings are limited by the small number of patients and have been disputed by a larger investigation [6].…”

Section: Discussionmentioning

confidence: 99%

Comprehensive ultrasound versus voiding cysturethrography in the diagnosis of vesicoureteral reflux

Muensterer

2002

Eur J Pediatr

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Assessment of increase in renal pelvic size on post-void sonography as a predictor of vesicoureteral reflux

Abstract: Increase in renal pelvic size on post-void ultrasound is not a reliable indicator of vesicoureteral reflux.

Cited by 28 publications

References 6 publications

Fluctuating fetal or neonatal renal pelvis: marker of high-grade vesicoureteral reflux

Fluctuating fetal or neonatal renal pelvis: marker of high-grade vesicoureteral reflux

Clinical effectiveness and cost-effectiveness of tests for the diagnosis and investigation of urinary tract infection in children: a systematic review and economic model

Comprehensive ultrasound versus voiding cysturethrography in the diagnosis of vesicoureteral reflux

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