To evaluate the impact of surgical intervention on long-term renal outcomes for adult patients with congenital ureteropelvic junction obstruction (UPJO).
MethodsWe queried service members diagnosed with UPJO from the United States Military Health System electronic health records from 2005 to 2020. We assessed demographic, laboratory, radiology, surgical intervention, and outcome data. We evaluated the impact of surgical intervention on renal function based on the estimated glomerular ltration rate (eGFR), hypertension (HTN, de ned as any prescription for blood pressure [BP] medication and/or average of two BP readings ≥ 130/80mmHg more than 2 weeks apart), and changes in renal excretory function on radionuclide scans.
ResultsWe identi ed 108 individuals diagnosed with congenital UPJO; mean follow-up of 7 years. Mean age at diagnosis was 25 years; 95% male; 69% White, 15% Black. At diagnosis, median BP was 130/78mmHg and mean eGFR 93ml/min/1.73m 2 . Subsequently, 85% had pyeloplasty and 23% had stent placement. There were no signi cant differences in mean eGFR pre-and post-intervention (94 vs 93 ml/min/1.73m 2 , respectively; p = 0.15) and prevalence of de ned HTN (59% vs. 61%, respectively; p = 0.20). Surgical intervention for right-sided UPJO signi cantly reduced the proportion of patients with delayed cortical excretion (54% pre vs. 35% post, p = 0.01) and T½ emptying time (35 min vs. 19 min, p = 0.009). Similar trends occurred with left-sided UPJO but were not signi cant.
ConclusionSurgical intervention was not associated with signi cant differences in the long-term outcomes of kidney function and HTN prevalence in our young adult cohort. However, renal excretory function improved on radionuclide scans.
