Clinical outcome is associated with the Urinary Tract Dilatation Classification System grade

Bratina, Petra; Levart, Tanja Kersnik

doi:10.3325/cmj.2020.61.246

Cited by 7 publications

(5 citation statements)

References 17 publications

(20 reference statements)

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“…7–10 To date, however, no cohort study has directly addressed the question whether UTD classification is able to predict long-term outcomes like renal injury. Recently, Bratina and Kersnik Levart showed in a cohort of 166 neonates with a short followup (median 24 months) no renal dysfunction; 11 therefore, this parameter cannot be associated with the UTD grade.…”

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confidence: 99%

“…The primary endpoint for this study was time until the occurrence of renal injury (defined as a composite event, including proteinuria, hypertension and CKD). Among 447 patients included in the analysis, 11 (2.5%) had hypertension, 13 (2.9%) had mild proteinuria, 14 (3%) developed CKD Stage 2 and 26 (5.8%) had renal injury. The prevalence of the events according to the UTD grade is shown in the figure.…”

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confidence: 99%

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Evaluation of Urinary Tract Dilation Classification System for Prediction of Long-Term Outcomes in Isolated Antenatal Hydronephrosis: A Cohort Study

et al. 2021

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The aim of this study was to evaluate the performance of the new classification of urinary tract dilatation (UTD) to predict long-term clinical outcomes in infants with isolated antenatal hydronephrosis (ANH).Materials and Methods: Between 1989 and 2019, 447 infants diagnosed with isolated severe ANH and were prospectively followed. The main predictive variable for the analysis was the new UTD classification system. The events of interest were surgical interventions, urinary tract infections, chronic kidney disease stage II or higher, hypertension and proteinuria. The primary end-point was time until the occurrence of a composite event of renal injury, including proteinuria, hypertension and chronic kidney disease.Results: Among 447 infants with ANH included in the analysis, 255 (57%) had UTD P1, 93 (20.8%) UTD P2 and 99 (22.2%) UTD P3. Median followup time was 9 years (IQR 7e12 years). Of 447 patients included in the analysis, 11 (2.5%) had hypertension, 13 (2.9%) exhibited persistent mild proteinuria, 14 (3%) developed chronic kidney disease Stage 2 and 26 (5.8%) had the composite outcome of renal injury. By survival analysis, the UTD system predicted accurately all events of interest. According to the KaplaneMeier survival analysis, the probability of renal injury at 20 years of age was estimated at about 0%, 14% and 56% for patients assigned to UTD P1, UTD P2 and UTD P3, respectively (p <0.001).Conclusions: Our findings provide insights that the new UTD classification has a good performance for discriminating not only mid-term, but also long-term clinical outcomes, including renal injury.

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confidence: 99%

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confidence: 99%

Evaluation of Urinary Tract Dilation Classification System for Prediction of Long-Term Outcomes in Isolated Antenatal Hydronephrosis: A Cohort Study

et al. 2021

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“…По данным нашего исследования категория UTD, определенная при первичном УЗИ, ассоциировалась с исходами пациентов с расширением ЧЛС: чем выше была категория UTD, тем реже происходило ее уменьшение в процессе наблюдения, реже категория оставалась прежней, чаще требовалось хирургическое вмешательство. Полученные результаты совпадают с данными зарубежных авторов, которые отмечают высокую корреляцию категорий UTD с клиническими исходами пациентов -необходимостью хирургического вмешательства, спонтанным разрешением и его сроком, частотой инфекций мочевых путей [10][11][12][13][14][15].…”

Section: Discussionunclassified

“…В нашем исследовании за период наблюдения уменьшение категории UTD до 0-I произошло у -/35/29/10% детей с первично установленной категорией UTD I/II/III (всего 24%). Совокупно доля Подобные результаты получены в ретроспективном исследовании P. Bratina и соавт., в которое вошло 166 новорожденных с расширением ЧЛС вследствие разных причин (медиана возраста первого УЗИ составила 5 дней, медиана периода наблюдения -24 мес) [15]. Спонтанное разрешение расширения ЧЛС произошло у 70/46/10% пациентов (всего 34%); хирургическое вмешательство проведено 0/14/62% пациентов с категорией UTD I/II/III (всего 34%) соответственно.…”

Section: Discussionunclassified

“…Спонтанное разрешение гидронефроза авторы разных публикаций определяли как "нормализацию" ультразвуковой картины и отсутствие клинических проявлений при последующем наблюдении [11,14,15] или уменьшение размеров лоханки до 10 мм и менее [13]. В нашей работе подобный исход соответствовал уменьшению категории UTD до 0-I в соответствии с рекомендациями C.P.…”

Section: Discussionunclassified

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Clinical application of new classification of the calyx-pelvic system dilation UTD in children in a perinatal center

Sugak,

Babatova,

Filippova

et al. 2023

Medicinskaâ vizualizaciâ

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The aim of the study was to evaluate the clinical significance of the new urinary tract dilation classification (UTD-2014) in predicting outcomes of the calyx-pelvic system dilation detected by ultrasound (US) in children in the perinatal center.Materials and methods. A retrospective analysis of the urinary system ultrasound protocols and the outcomes of 152 children with dilated calyx-pelvic system due to various causes examined at the National Medical Research Center for Obstetrics, Gynecology and Perinatology for the period from 2017 to 2022 was carried out.Results. The median age of patients at the time of the first ultrasound was 2 days, the median duration of follow -up was 10 months. The decrease in the UTD category during the observation period occurred in –/35/29/10% of patients in groups with the primary established UTD category 0/I/II/III, respectively. The UTD category remained the same in 42%, an increase in the category occurred in 32/26/4/-% of patients with UTD 0/I/II/III, respectively. The age at the time of the first ultrasound of patients who had an increase in the UTD category (median – 2 (1; 3.5) days) was significantly less than in other children (with the exception of operated patients). Surgical intervention was performed by 0/2/31/60% of patients with UTD category 0/I/II/III (only 18%), respectively.Conclusions. UTD classification correlates well with outcomes of the calyx-pelvic system dilation due to various causes in children – the larger the category according to primary ultrasound, the less often its decrease or lack of dynamics is noted during follow-up, surgical treatment is more often necessary. When using the UTD classification in the perinatal center, there is a high risk of underestimating the degree of dilatation due to the early conduct of the first ultrasound in the first two days of life.

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2021 update on the urinary tract dilation (UTD) classification system: clarifications, review of the literature, and practical suggestions

et al. 2022

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Clinical outcome is associated with the Urinary Tract Dilatation Classification System grade

Cited by 7 publications

References 17 publications

Evaluation of Urinary Tract Dilation Classification System for Prediction of Long-Term Outcomes in Isolated Antenatal Hydronephrosis: A Cohort Study

Evaluation of Urinary Tract Dilation Classification System for Prediction of Long-Term Outcomes in Isolated Antenatal Hydronephrosis: A Cohort Study

Clinical application of new classification of the calyx-pelvic system dilation UTD in children in a perinatal center

2021 update on the urinary tract dilation (UTD) classification system: clarifications, review of the literature, and practical suggestions

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