Hydronephrosis in pediatric kidney transplant: Clinical relevance to graft outcome

Chu, Liu; Jacobs, Bruce L.; Schwen, Zeyad; Schneck, Francis X.

doi:10.1016/j.jpurol.2012.02.012

Cited by 15 publications

(11 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In those patients, the absence of renal scarring, recurrent UTI, and VUR less than grade 5 were predictors of successful management without surgery . While transplant hydronephrosis in the absence of VUR has been correlated with worsened graft function and pyelonephritis, this is due to ureteral obstruction, which poses a greater threat to the graft than VUR without UTI.…”

Section: Discussionmentioning

confidence: 99%

When does vesicoureteral reflux in pediatric kidney transplant patients need treatment?

Concepcion

Grimm

2018

Pediatric Transplantation

View full text Add to dashboard Cite

Purpose The treatment of VUR in children with UTI has changed significantly, due to studies showing that antibiotic prophylaxis does not decrease renal scarring. As children with kidney transplants are at higher risk for UTI, we investigated if select patients with renal transplant VUR could be managed without surgery. Materials and Methods A total of 18 patients with VUR into their renal grafts were identified, and 319 patients underwent transplantation from 2006 to 2016. The cause for the detection of the VUR, treatment, and graft function was reviewed. Results Six boys and 12 girls were identified, 13 of whom had grade 3 or 4 VUR into the renal graft. Nine patients presented with hydronephrosis or abnormal renal biopsy: eight were successfully managed with antibiotic prophylaxis and bladder training, one developed UTI and underwent Dx/HA subureteric injection. Nine patients presented with recurrent febrile UTI, only one was successfully managed without surgery. Only 2 of 9 (22%) patients who underwent Dx/HA injection had resolution of their reflux. Of the remaining seven, five required open ureteral reimplantation (two for obstruction), one lost the graft due to rejection, and one had significant hydronephrosis. eGFR was similar between the hydronephrosis, UTI, and abnormal renal biopsy groups at all times. Conclusion Patients with transplant VUR and recurrent febrile UTI are more likely to require surgical therapy, but the complication and failure rate for Dx/HA injection is significant. Patients with transplant VUR without febrile UTI can be successfully managed with bladder training and temporary antibiotic prophylaxis.

show abstract

Section: Discussionmentioning

confidence: 99%

When does vesicoureteral reflux in pediatric kidney transplant patients need treatment?

Concepcion

Grimm

2018

Pediatric Transplantation

View full text Add to dashboard Cite

show abstract

“…Pediatric post-transplant hydronephrosis has correlated with worsening renal function and increased incidence of pyelonephritis, necessitating more aggressive preoperative and postoperative urologic testing and management (13). Most of the testing and management require US or endo-ureteral imaging, and its role and a proposed algorithm are outlined nicely by Barrero et al (14).…”

Section: Not Usedmentioning

confidence: 99%

Renal Relevant Radiology

Sharfuddin

2014

Clinical Journal of the American Society of Nephrology

View full text Add to dashboard Cite

SummaryKidney transplantation can be associated with various complications that vary from vascular complications to urologic disorders to immunologic adverse effects. In evaluating the recipient with graft dysfunction, clinicians can choose among several imaging modalities, including ultrasonography, nuclear medicine studies, computed tomography, and magnetic resonance imaging. This review discusses the evaluation of the kidney transplant recipient using these imaging procedures, emphasizing the clinical diagnostic utility and role of each modality. A kidney biopsy is often required as a gold standard for diagnostic purposes. However, because of the inherent risks of a kidney biopsy, noninvasive imaging in diagnosing causes of graft dysfunction is a highly desired tool used and needed by the transplant community. Because the diagnostic accuracy varies depending on the time course and nature of the transplant-related complication, this review also addresses the advantages and limitations of each modality. The recent advances in kidney transplant imaging techniques and their clinical implications are also discussed.

show abstract

“…In recent years, with the improvement of imaging techniques and prenatal care systems, a growing number of cases of pediatric hydronephrosis have been detected in the early prenatal period and followed up ( 1 , 2 ). In addition, an increasing number of cases of pediatric ampullary renal pelvis (ARP), which is challenging to distinguish from hydronephrosis, have been diagnosed in postnatal follow-up observations ( 3 ).…”

Section: Introductionmentioning

confidence: 99%

Diagnosis of 65 cases of ampullary renal pelvis after postnatal follow-up of 1,167 newborn infants with prenatally suspected hydronephrosis

Zhang¹,

Liu²,

Fujiang³

et al. 2014

Experimental and Therapeutic Medicine

View full text Add to dashboard Cite

The aim of the present study was to assess the morbidity of ampullary renal pelvis (ARP) and document its natural history in post-natal life. A total of 1,167 newborn infants with prenatally suspected hydronephrosis were retrospectively analyzed. Of these, 65 patients were diagnosed with ARP by computed tomography urography (CTU) and/or magnetic resonance urography (MRU). All cases were followed up with ultrasonogrophy at 1, 3, 6 and 12 months after birth, and one case was followed up for 5 years. Changes in the separation of the renal pelvis collection system were recorded. Children with ARP accounted for 5.57% of the total cases (65/1,167) followed-up. No lack of connection between the renal calyces and the renal pelvis was detected. The long-term follow-up revealed that the separation of the renal pelvis collection system did not tend to increase over time. In addition to imaging examinations, long-term follow-up observation is recommended for the accurate diagnosis of pediatric ARP, particularly for differentiation from hydronephrosis.

show abstract

Hydronephrosis in pediatric kidney transplant: Clinical relevance to graft outcome

Cited by 15 publications

References 16 publications

When does vesicoureteral reflux in pediatric kidney transplant patients need treatment?

When does vesicoureteral reflux in pediatric kidney transplant patients need treatment?

Renal Relevant Radiology

Diagnosis of 65 cases of ampullary renal pelvis after postnatal follow-up of 1,167 newborn infants with prenatally suspected hydronephrosis

Contact Info

Product

Resources

About