Predictors for the need of surgery in antenatally detected hydronephrosis due to UPJ obstruction – A prospective multivariate analysis

Arora, Sohrab; Yadav, Priyank; Kumar, Mayank; Singh, Shanker K.; Sureka, Sanjoy Kumar; Mittal, Varun; Ansari, M.S.

doi:10.1016/j.jpurol.2015.02.008

Cited by 56 publications

(37 citation statements)

References 17 publications

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“…In spite of the availability of valuable approaches for outcome evaluation of fetal HY, including the SFU and APD grading systems (15), controversy remains regarding the post-partum management on the determination of surgery (25,26). To date, certain parameters have been identified as indicators for the requirement of surgery, including ureteropelvic junction obstruction (27), the renal parenchyma to hydronephrosis area ratio (28) and cortical transit time (29). The present study also assessed the association of the SFU and APD grades with the surgery rate.…”

Section: Univariate Analysis Multivariate Analysis ------------------mentioning

confidence: 99%

Ultrasound evaluation for prediction of outcomes and surgical decision in fetal hydronephrosis

et al. 2019

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Section: Univariate Analysis Multivariate Analysis ------------------mentioning

confidence: 99%

Ultrasound evaluation for prediction of outcomes and surgical decision in fetal hydronephrosis

et al. 2019

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“…23,24 Therefore, in the present study, we considered >10% reduction in DRF as a decrease in renal function, as proposed by other studies. 6,25 There is no consensus on the method or duration of follow up for postoperative assessment of HN after pyeloplasty. 12,26 Although US provides useful anatomical information, it does not provide functional information.…”

Section: Discussionmentioning

confidence: 99%

Best ultrasound parameter for prediction of adverse renal function outcome after pyeloplasty

et al. 2020

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Objective To evaluate the clinical value of preoperative ultrasound parameters for post‐pyeloplasty outcomes in pediatric patients with ureteropelvic junction obstruction. Methods The medical records of 187 pediatric and adolescent patients who underwent pyeloplasty as a result of ureteropelvic junction obstruction between 2010 and 2016 were retrospectively reviewed. The severity of hydronephrosis was measured by the Society for Fetal Urology grade, anteroposterior pelvic diameter, urinary tract dilation, hydronephrosis index, and the hydronephrosis area to renal parenchyma ratio at 3, 6 and 12 months. Adverse renal function outcome was defined as ≥10% decrease in postoperative differential renal function compared with preoperative values. Results Of the 187 patients, preoperative hydronephrosis was categorized as Society for Fetal Urology grade 3 in 26 patients (13.9%) and grade 4 in 161 patients (86.1%). No surgical failures, defined as requirement of repeat surgery or deterioration of hydronephrosis grade, were noted. The mean changes in Society for Fetal Urology grade, anteroposterior pelvic diameter, urinary tract dilation and hydronephrosis area to renal parenchyma ratio showed similar trends of recovery during the follow‐up period. In total, 19 patients (10.2%) showed >10% decrease in differential renal function during follow up (mean 42 months). Multivariate logistic regression analysis showed that the hydronephrosis area‐to‐renal parenchyma ratio was the only significant prognostic factor for adverse renal function outcome (hazard ratio 1.806, 95% confidence interval 1.210–2.859, P = 0.005). Receiver operating characteristic analysis showed that the hydronephrosis area‐to‐renal parenchyma ratio was the most significant predictive value (area under the curve 0.711, 95% confidence interval 0.618–0.804, P = 0.006). Conclusions Pediatric patients with high hydronephrosis area‐to‐renal parenchyma ratio values before surgery are more likely to show renal function decline after pyeloplasty.

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“…Moreover, subjective determination of parenchymal thickness may cause more conflicting results. Correlation between parenchymal thickness and prognosis is not clear even in postnatal studies (38). Nevertheless, loss of uniform structure of the renal parenchyma, presence of peri-cortical renal cysts (Figure 5c) and increased renal parenchymal echogenicity in prenatal ultrasound are associated with impaired renal function (Figures 3b, 5b) (39).…”

Section: Parameters Determining Poor Prognosis In Prenatal Upjhnmentioning

confidence: 99%

Prenatal Diagnosis and Findings in Ureteropelvic Junction Type Hydronephrosis

Has

Sivrikoz

2020

Front. Pediatr.

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Predictors for the need of surgery in antenatally detected hydronephrosis due to UPJ obstruction – A prospective multivariate analysis

Cited by 56 publications

References 17 publications

Ultrasound evaluation for prediction of outcomes and surgical decision in fetal hydronephrosis

Ultrasound evaluation for prediction of outcomes and surgical decision in fetal hydronephrosis

Best ultrasound parameter for prediction of adverse renal function outcome after pyeloplasty

Prenatal Diagnosis and Findings in Ureteropelvic Junction Type Hydronephrosis

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