Mp64-15 hydronephrosis Following Ureteral Reimplantation: When Is It Concerning?

Abstract

scan. Outcomes of interest were hypertension, proteinuria and kidney disease (CKD stages II-IV or ESRD). These 3 outcomes were also considered as a composite outcome. Kaplan-Meier survival curves were constructed and association of initial RS with event-free survival was analyzed using Log-Rank test.RESULTS: Among 745 eligible patients, 393 (53%) had RS on DMSA scan and 352 (47%) did not. There was no significant difference in median age (4 vs 3 years) or follow up time (5.6 vs 5.5 years). The RS cohort had fewer females (68% vs 84%, p < 0.001) and a higher proportion of patients with VUR grades IV or V (28% vs 13%). RS patients were more likely to undergo surgical repair of VUR (59% vs 26%, p < 0.001) at a median of 83 days (IQR 35-370) after initial DMSA scan.Significantly more patients with RS developed proteinuria (5.1% vs 1.6%, p [ 0.005) and kidney disease (2% vs 0%, p [ 0.005; Table 1). Hypertension occurred in 2.8% of patients with RS and 1% of those without (p [ 0.09). Kaplan-Meier curves stratified by cohort demonstrate significantly increased probability of adverse renal outcomes for those with RS (6.2% vs 2.6%, p [ 0.02; Figure 1).CONCLUSIONS: In this cohort study, patients with RS were significantly more likely to develop proteinuria and kidney disease. Serial, longitudinal evaluation is essential for these at-risk children.