Sonographic Evaluation of Hydronephrosis and Determination of the Main Causes among Adults

Abstract

Abstract:Background: hydronephrosis is one of the most common complication of renal obstructive diseases, if left untreated, it may cause severe complications which may lead to acute and chronic renal failure. Objectives: to assess and classify hydronephrosis and determine the causes using ultrasound. Materials and methods: It is a prospective study, the study population composed of 53 female and 47 male who were suspected with renal diseases and referred to the ultrasound department for investigation. Data collection sheet was designed to include the demographic data such as age, gender, and clinical history. All the patients had been examined with ultrasound using the abdomen and renal ultrasound imaging protocol with 3.5 MHz probe. The renal system (kidneys, urinary bladder and prostate) had been scanned, longitudinal and transverse sections were performed through the kidneys and prostate. Hydronephrosis and the underline causes were measured and reported. Statistical analysis was performed using the standard Statistical Package for the Social Sciences (SPSS Inc., Chicago, IL, USA) version 16 for windows.Descriptive statistics was used to analyze the data. Results: According to sonographic appearance, hydronephrosis had been classified into mild, moderate and severe hydronephrosis. Mild hydronephrosis is most common (53%), moderate (30%), severe hydronephrosis (13%) and extreme hydronephrosis was 4%. There were various causes of hydronephrosis, ureteric stone 31%, kidney stone 23%, pregnancy 12% and benign prostatic hypertrophy 11%. Most of the study population had history of renal stones (63%) Conclusion: Ultrasound is the first line of investigation of the renal system. It is sensitive and accurate to assess and classify the hydronephrosis and determine the main causes. Metabolic disorders (gout and diabetes) were the most risk factors of renal obstructive diseases.

Sonographic determination of the association between grades of hydronephrosis and detection of kidney and ureteric calculi.

“…The severity of hydronephrosis was shown to be correlated with the presence of detected stones. This was consistent with a recent research by Suzan et al who found that renal stones were the cause of hydronephrosis in 54% of adult patients 17 58.4% of the patients in this research were male, whereas 41.5% were female. Renal calculi were more common in men as they were in women, which is consistent with findings from prior research by Nuraj P et al 18 The distribution of hydronephrosis grades in this research is comparable to that reported by Nuraj P et al 6 who found a prevalence of 48% for grade 2, 22.8% for grade 1, 16.2% for grade 3, and 12.5% for grade 4, and that by Alshoabi 8 as well.…”

“…21 Another research by Suzan Omer Abdelmaboud et al found that 53% of Khartoum residents with hydronephrosis had only mild symptoms, whereas 30% had moderate symptoms, and 13% had severe symptoms, based on ultrasound evaluations, and therefore it may be prudent to screen all patients with even mild symptoms for the presence of renal and ureteric stones. 17 The majority of patients were from the very low and low income status, and a study showed that patients with lower education levels and from regions of lower mean income were found to be more likely to present to our tertiary care center with a greater stone burden, and the majority of patients in our study had grade 3 hydronephrosis. 22 However, in certain situations, a more thorough diagnosis may need the use of additional imaging modalities, such as CT or MRI.…”

Association between grades of Hydronephrosis & detection of urinary stones by ultrasound imaging

“…These results are consistent with a previous study by Suzan et al (2015), who reported that kidney and ureteric stones were the cause of hydronephrosis in 54% of adult patients. 8 The gender distribution of the patients in the sample of this study was 67.14% males vs. 32.86% females. This result is compatible with previous studies by Hall (2009) and Nuraj P et al (2017), who reported that renal calculi in males were nearly twice as it was in females.…”

B-Mode Sonography Versus Color Doppler Twinkling Artifact in the Diagnosis of Nephrolithiasis

“…Comparative analyses with prior studies reveal interesting parallels and deviations in the detection rates and clinical presentations of HDN. For instance, Suzan et al categorized HDN sonographically into three types, identifying mild HDN as the most common, occurring in approximately 53% of cases, followed by moderate HDN in 30%, severe HDN in 13%, and extreme HDN in a mere 4% of patients (14). Similarly, Jacob et al linked the grade of HDN observed on ultrasonography with the size of kidney stones, noting that a significant majority of patients with mild HDN harbored smaller urethral stones measuring under 5mm (15).…”