Surgical treatment reduces blood pressure in children with unilateral congenital hydronephrosis

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

“…independently associated with the occurrence of HY regression, which implied that these two grading systems may be used to predict post-partum HY regression. The predominant treatment for persistent fetal HY is surgery and the prognosis is favorable (24). 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).…”

Hydronephrosis is associated with elevated plasmin in urine in pediatric patients and rats and changes in NCC and γ-ENaC abundance in rat kidney

“…Hydronephrosis correlated negatively with the 37kDa band in the obstructed, UPJO+ kidney (p=0.02), while no correlations were detected with the other bands (table 2) (13). We found in a small prospective study that systolic and diastolic pressures were reduced following surgical correction of hydronephrosis in children with pelvic-ureteric junction obstruction (3). In adult unilateral hydronephrosis, cases showed that nephrectomy or pyeloplasty turned patients normotensive (1,13,29,37).…”

“…Hypertension is attenuated or even cured following relief of the obstruction or, notably, by removal of the hydronephrotic kidney (12). Moreover, recent studies show that ambulatory blood pressure in pediatric patients with congenital hydronephrosis is higher compared with healthy controls, and surgical correction of the obstruction significantly lowers blood pressure (2,3). Thus, preclinical and clinical findings indicate that the UPJO kidney contributes to the development of hypertension, which is of salt-sensitive nature.…”

Hydronephrosis and risk of later development of hypertension

“…In two recent small clinical studies the effect of congenital hydronephrosis, due to UPJO, on blood pressure regulation has been investigated . Both studies showed that ambulatory blood pressure in hydronephrotic patients aged from infancy to 13 years of age was significantly higher before surgery compared with that measured six months following surgical management (i.e.…”

“…Figure is modified with permission from previous original publications, i.e. (A) by Carlstrom et al , (B–E) by Peleli et al , (G–I) by Al‐Mashhadi et al .…”