Classification of pediatric urinary tract dilation: the new language

Chow, Jeanne S.; Koning, Jeffrey L.; Back, Susan J.; Nguyen, Hiep T.; Phelps, Andrew; Darge, Kassa

doi:10.1007/s00247-017-3883-0

Cited by 34 publications

(19 citation statements)

References 23 publications

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“…UTD was categorized as group P1, P2 or P3, as described previously, but by using a numeric value. 13 APPD was defined as the renal transverse distance; namely, the diameter of the renal pelvis bordered by the edges of the renal parenchyma. 14 HARP was calculated by dividing the total HN area by the RPA, which was measured using the Picture Archiving and Communication System.…”

Section: Methodsmentioning

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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Section: Methodsmentioning

confidence: 99%

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

et al. 2020

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“…Established in 2014, the Urinary tract dilation (UTD) classification system is a system developed by representatives from societies which specialize in the diagnosing and treatment of fetuses and children with hydronephrosis While there are only three antenatal subclassifications (normal, UTD A1, UTD A2-3), four subclassifications are defined in the postnatal period (normal, low risk (UTD P1); intermediate risk (UTD P2); and high-risk (UTD P3) (45).…”

Section: Utd Classificationmentioning

confidence: 99%

“…While there are only three antenatal subclassifications (normal, UTD A1, UTD A2–3), four subclassifications are defined in the postnatal period (normal, low risk (UTD P1); intermediate risk (UTD P2); and high-risk (UTD P3) ( 45 ).…”

Section: Utd Classificationmentioning

confidence: 99%

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Urinary Ultrasound and Other Imaging for Ureteropelvic Junction Type Hydronephrosis (UPJHN)

Uçar

Kuruğoğlu

2020

Front. Pediatr.

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Ultrasound is the main imaging study used to diagnose ureteropelvic junction (UPJ) obstruction. On ultrasound, abnormal dilatation of the pelvicalyceal system of varying degrees is seen, whereas the ureter is normal in caliber. A properly performed study provides essential information regarding laterality, renal size, thickness, and architecture of the renal cortex and degree of dilatation of the pelvicalyceal system. Doppler ultrasound may identify a crossing vessel, when present. This imaging method also has been used differentiating obstructive from non-obstructive hydronephrosis by renal arterial resistive index measurements. Abdominal radiographs may show soft tissue fullness, bulging of the flank, and displacement of bowel loops from the affected side. The voiding/micturating cystourethrogram helps exclude other causes of upper tract dilatation, including vesicoureteral reflux, urethral valves, and ureteroceles. Computerized Tomography angiography with multiplanar reformation and three-dimensional images may be used to depict suspected crossing vessels as a cause of UPJ obstruction in older children and adults. Magnetic Resonance Urography has progressed significantly in recent years due to the development of both hardware and software that are used to generate high-resolution images. This imaging technique currently allows for the detailed assessment of urinary tract anatomy, while also providing information regarding renal function, including differential renal function, and the presence or absence of obstructive uropathy.

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“…The six common descriptions are (1) anterior posterior renal pelvic diameter, (2) calyceal dilation, (3) ureteral dilation, (4) renal parenchymal thickness, (5) renal parenchymal echogenicity, and (6) bladder appearance. In fetuses, oligohydramnios which may be due to urinary tract abnormalities is also described [6][7][8].…”

Section: Kidneysmentioning

confidence: 99%