Evaluation of prenatally diagnosed hydronephrosis by morphometric measurements of the kidney

Blachar, Arye; Schächter, M; Blachar, Yoram; Mogilner, B.M.; Zurkowski, L; Livne, Pinhas M.; Pelet, Deborah; Appleman, Z.; Caspi, B.

doi:10.1007/bf02020171

Cited by 14 publications

(7 citation statements)

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“…Fifty-three were followed for 2 years. In all of them, a diagnosis of pelvic dilatation (renal pelvic diameter of !4 mm in the second trimester or !7 mm in the third trimester or both) [1,2,3,4] had been made by routine prenatal ultrasonography. The study included a clinical survey, comprehensive family history, dynamic renal scanning by Tc-99m diethylene triamine penta-acetic acid (DPTA), and direct cystography with 99m Tc-pertechnetate.…”

Section: Methodsmentioning

confidence: 99%

“…Several studies have addressed the postnatal outcome of infants diagnosed prenatally with hydronephrosis. These studies stress the importance of follow-up to ensure early detection of uromechanical changes and appropriate intervention [2,3,4]. Extra renal pelvis (ERpel) is defined as a pelvis that lies almost outside the renal sinus, in comparison with intrarenal pelvis, which lies entirely within the kidney [5], regardless of its anteroposterior diameter.…”

Section: Introductionmentioning

confidence: 99%

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Neonates with extra-renal pelvis: the first 2 years

et al. 2005

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Extra-renal pelvis (ERpel) is a common ultrasonographic finding among neonates who have undergone recurrent ultrasound examinations for a better definition of prenatal renal pelvic dilatation. This study tries to determine whether or not ERpel has important prognostic implications. Seventy-nine neonates (17 female) were examined. All had a diagnosis of prenatal renal pelvis dilatation, which was shown by postnatal ultrasound to be ERpel. Sixty ERpel neonates were examined 1.5 months to 2.5 months after the ultrasound (US) diagnosis by both Tc-99m diethylene triamine penta-acetic acid (DPTA) dynamic renal scanning and (99m)Tc-pertechnetate direct cystography. Clinical assessment, urine cultures and renal ultrasound follow-up were maintained for 2 years. The proportion of urinary tract infections (UTIs) in patients with ERpel was compared with that of the total neonatal and infantile population with normal US scans in the region of our hospital. Associated minor congenital malformations were found in 12 of 79 neonates (15.2%). Four had a family history of ERpel. Among 60 neonates who underwent renal scanning, 36 (60%) were found to have urinary retention in the collecting system. Another nine (15%) had vesico-ureteral (VU) reflux, of which seven had urinary retention. Fifteen (25%) showed normal isotope imaging. Urinary tract infection was diagnosed in 16 ERpel neonates in whom only one exhibited VU reflux (grade 2). The incidence of neonatal UTI in the ERpel group was more than that of either neonatal or infantile UTI in those with normal US scans in the local population (20.2% vs 1.2% and 4.3%, respectively). Fifty-three infants completed a 2-year follow-up. Repeat renal ultrasonography indicated that one infant (1.8%) had developed bilateral hydronephrosis, 12 (22.6%) had unchanged findings, 18 (40%) showed an improvement (decrease of ERpel width or resolution in one side) and, in 22 (41.5%) infants, the condition had resolved. No clinical or kidney function deterioration was observed. Seven patients (13.2%) each had one episode of UTI during the 2-year follow-up period; none of them had VU reflux. Neonatal ERpel is more frequent in male infants. It is associated with greater rates of minor congenital malformations, VU reflux and UTI than in the general population of the same ages. The increased UTI incidence is not attributed to VU reflux.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Neonates with extra-renal pelvis: the first 2 years

et al. 2005

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“…Hydronephrosis was graded by pelvic diameter according to the anterior-posterior diameter classification criteria as normal (0-4 mm), mild (5-9 mm), moderate (10-15 mm), and severe (Ͼ15 mm). 5 Data recorded consisted of demographics and ultrasound-derived serial measurements of kidney size and pelvic diameter. Change in grade of hydronephrosis within each patient was defined by the status of the more severely affected kidney.…”

Section: Methodsmentioning

confidence: 99%

Outcome of Isolated Antenatal Hydronephrosis

Cheng¹,

Phan²,

Geary³

et al. 2004

Arch Pediatr Adolesc Med

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“…[ 7 ] Hydronephrosis was graded by pelvic diameter according to the anterior–posterior diameter classification criteria as normal (0–4 mm), mild (5–9 mm), moderate (10–15 mm), and severe (>15 mm). [ 9 ] We formed two groups; the first group was composed of patients with severe hydronephrosis and the second group composed of patients with mild-to-moderate hydronephrosis.…”

Section: Methodsmentioning

confidence: 99%

Correlation of ultrasonographical findings of hydronephrosis/atrophy with 99m technetium-dimercaptosuccinic acid in childhood: A single-center experience from Turkey

2018

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Introduction:To assess the association of frequently detected abnormalities (hydronephrosis and/or atrophy) on renal ultrasound with dimercaptosuccinic acid (DMSA) scan and the impact of vesicoureteral reflux (VUR) on these abnormalities to find new perspectives in pediatric age group.Materials and Methods:We retrospectively reviewed the DMSA, ultrasonography (US), micturating cystourethrography (MCUG) findings, and medical records of pediatric patients with hydronephrosis and/or atrophy who were at follow-up between January 2013 and December 2016 in our center which is located in the southeast region of Turkey.Results:Among 148 pediatric patients (male/female = 60/88), 66 had hydronephrosis, 72 had atrophy, and 10 patients had both. MCUG study detected VUR in 66 patients. Patients with atrophy were significantly older than patients with hydronephrosis (77.8 ± 58.6 vs. 39.3 ± 38.9 months, P = 0.002). Only 19.4% of our patients with atrophy had VUR. The rate of VUR was higher in the high-grade group than the mild-to-moderate-grade group although the difference was not statistically significant (80% vs. 61%, P = 0.199). Patients with high-grade hydronephrosis had more severe DMSA findings (73% vs. 39%). On the other side, 79% of the patients with high-grade VUR had severe DMSA findings. A total of 10 patients had both atrophy and hydronephrosis all affecting the left side. Six of them had VUR. Severe DMSA findings were more likely in toddlers (age 24–72 months) (48%). This finding was abruptly lowered after 72 months of age.Conclusions:The presence of atrophy and cases of left-sided hydronephrosis should be closely monitored, and DMSA may not be necessary in cases with high-grade hydronephrosis before MCUG.

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Evaluation of prenatally diagnosed hydronephrosis by morphometric measurements of the kidney

Cited by 14 publications

References 10 publications

Neonates with extra-renal pelvis: the first 2 years

Neonates with extra-renal pelvis: the first 2 years

Outcome of Isolated Antenatal Hydronephrosis

Correlation of ultrasonographical findings of hydronephrosis/atrophy with 99m technetium-dimercaptosuccinic acid in childhood: A single-center experience from Turkey

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