Changes in Differential Renal Function after Pyeloplasty in Children

Harraz, Ahmed M.; Helmy, Tamer E.; Taha, Diaa‐Eldin; Shalaby, Ibrahim; Sarhan, Osama; Dawaba, Mohamed; Hafez, Ashraf T.

doi:10.1016/j.juro.2013.01.004

Cited by 25 publications

(25 citation statements)

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“…Early diuretic renogram with a normal excretion curve after paediatric pyeloplasty has been found to be an excellent predictor of a good surgical outcome and make recurrence unlikely . Regarding SRF, improvement after pyeloplasty is expected even in patients with preoperative renal function of <30%, in accordance with the report by Bansal et al . In addition, in the present study, we did not observe late recurrence of obstruction in patients with a normal excretion pattern at 1 week after stent removal; therefore, normal excretion pattern and improved SRF on early renogram 1 week after stent removal probably provide safe grounds for discharge from follow‐up.…”

Section: Discussionsupporting

confidence: 91%

Early mercaptoacetyltriglycine(MAG‐3) diuretic renography results after pyeloplasty

2016

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There is no agreement regarding the 'gold standard' investigation to use after pyeloplasty for PUJ obstruction. Improvement in hydronephrosis on US is slow and often takes > 12 months. Based on animal studies, it is possible that missed recurrent obstruction will cause irreversible loss of renal function after 6 weeks; therefore, early postoperative assessment is desirable, but there have been few reports on urinary drainage changes with early diuretic renography after pyeloplasty. Most of the renal units had improved drainage on diuretic renography 7 weeks after pyeloplasty and 1 week after stent removal. An early diuretic renogram is a reliable method of documenting surgical success after pyeloplasty.

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Section: Discussionsupporting

confidence: 91%

Early mercaptoacetyltriglycine(MAG‐3) diuretic renography results after pyeloplasty

2016

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“…This finding was previously reported in both an adult and pediatric cohort [4,5,6]. The less the initial DRF is, the more room there is for DRF to improve.…”

Section: Discussionsupporting

confidence: 84%

“…Although the goal of pyeloplasty is primarily to preserve renal function and provide symptomatic relief, recoverability of renal function is a matter of debate and has been a subject of extensive literature research, especially in the pediatric population [1,3,6,9,10,11]. We showed that the overall DRF and SKGFR were significantly improved after relief of obstruction.…”

Section: Discussionmentioning

confidence: 82%

“…Exclusion criteria included patients with bilateral UPJO, or UPJO in solitary kidney and presence of renal anomalies. Patients with preoperative DRF >65% were excluded as this will violate the assumption of normality of the contralateral kidney [4,6]. All patients underwent open pyeloplasty using the standard dismembered Anderson-Hyne's technique.…”

Section: Methodsmentioning

confidence: 99%

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Evaluation of Factors Predicting Recoverability of Renal Function after Pyeloplasty in Adults

et al. 2014

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Aim: To analyze the status of renal function after pyeloplasty in a large contemporary adult series and to detect which variables predict improvement of renal function. Materials and Methods: 85 adult patients were retrospectively identified who had undergone pyeloplasty between January 2002 and May 2011 with available pre- and postoperative diuretic scintigraphy. Preoperative differential renal function (DRF) and single-kidney GFR (SKGFR) were obtained by ^99mTc-MAG-3 diuretic scintigraphy. Baseline-weighted (bw-) DRF and SKGFR were calculated between baseline conditions and time of last follow-up. Factors that explain the variance of bw-DRF and bw-SKGFR were determined. Results: The mean (SD) preoperative DRF significantly increased from 34% (11.6) to 37.2% (11.8) after pyeloplasty (p < 0.001). Similarly, mean (SD) SKGFR showed a significant improvement from 31.2 (12.9) to 35.9 (15) ml/min (p < 0.001). Patients with a lower baseline DRF (≤40%) showed a significant improvement as opposed to those with a higher baseline DRF (>40%) (p < 0.001 and 0.3, respectively). Baseline DRF and cortical thickness explained the variance in bw-DRF and bw-SKGFR with more contribution of baseline DRF. Conclusions: Renal function showed improvement after pyeloplasty in adults and preoperative DRF and cortical thickness were the predicting variables.

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“…Stratification of patients based in PI-APD is a promising strategy for further minimizing radiation exposure while safely detecting children at risk for rUPJO. is the surgical procedure of choice to manage children with ureteropelvic junction obstruction (UPJO), with high reported success rates[1,2].…”

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confidence: 99%

Percent improvement in renal pelvis antero-posterior diameter (PI-APD): Prospective validation and further exploration of cut-off values that predict success after pediatric pyeloplasty supporting safe monitoring with ultrasound alone

Rickard

Braga

Oliveria

et al. 2016

Journal of Pediatric Urology

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Changes in Differential Renal Function after Pyeloplasty in Children

Abstract: Renal function improves after pyeloplasty in children. Baseline differential renal function and cortical thickness predict improvement after surgery.

Cited by 25 publications

References 29 publications

Early mercaptoacetyltriglycine(MAG‐3) diuretic renography results after pyeloplasty

Early mercaptoacetyltriglycine(MAG‐3) diuretic renography results after pyeloplasty

Evaluation of Factors Predicting Recoverability of Renal Function after Pyeloplasty in Adults

Percent improvement in renal pelvis antero-posterior diameter (PI-APD): Prospective validation and further exploration of cut-off values that predict success after pediatric pyeloplasty supporting safe monitoring with ultrasound alone

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