In Hydronephrosis Less than 10 % Kidney Function is not an Indication for Nephrectomy in Children

Aziz, Mohammed A.; Hossain, Ashfaque; Banu, Tahmina; Karim, Md. Sydul; Islam, Nahid; Sultana, Hajera; Alam, M. I.; Hanif, Asif; Khan, Akhtar

doi:10.1055/s-2002-35956

Cited by 44 publications

(38 citation statements)

References 5 publications

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“…However, dynamic renography may not reflect the true renal function in patients affected by severe hydronephrosis. This may contribute directly to the gradual increase in pressure in the renal pelvis [3], which may in turn prevent the absorption of the radionuclide imaging agent by the kidney, suggesting low renal function. Isoyama et al [13] also found that, although preoperative diuretic renography showed a non-functional kidney, renal function was remarkably improved postoperatively in some patients.…”

Section: Discussionmentioning

confidence: 99%

“…Hydronephrosis in infants and children is often associated with a short disease duration and only mildly impaired renal function. Furthermore, the kidneys are still developing in infants and children, allowing the potential for this organ to regain its normal function after timely relief from any obstruction [3,4]. However, kidneys in adults are fully developed, and the factors affecting the recoverability of renal function after surgery in adults with UPJO remain uncertain.…”

Section: Introductionmentioning

confidence: 99%

“…Treatment for UPJO therefore remains controversial, largely because of uncertain predictions regarding the postoperative recoverability of renal function. Urologists and nephrologists thus require managements or preoperative predictors to help them decide whether to perform nephrectomy or pyeloplasty [3]. The current study aimed to identify preoperative predictors of recoverability of renal function after Anderson-Hynes dismembered pyeloplasty to guide effective treatment decisions for adult patients with UPJO in a population.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Predictors of Recoverability of Renal Function after Pyeloplasty in Adults with Ureteropelvic Junction Obstruction

Wu¹,

Wei²,

Chen³

et al. 2018

Urol Int

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Background: This study aimed to identify factors predicting the recoverability of renal function after pyeloplasty in adult patients with ureteropelvic junction obstruction. Methods: We retrospectively reviewed 138 adults with unilateral renal obstruction-induced hydronephrosis and who underwent Anderson-Hynes dismembered pyeloplasty from January 2013 to January 2016. Hydronephrosis was classified preoperatively according to the Society for Fetal Urology (SFU) grading system. All patients underwent Doppler ultrasonography, excretory urography, computed tomography, and technetium-99m-diethylenetriamine pentaacetic acid radioisotope (99mTc DTPA) renography before and after surgery. Renal resistive index (RRI) and 99mTc DTPA renography were repeated at 1, 3, 6, and 12 months. Results: Multivariate analysis identified age, renal pelvic type, SFU grade, preoperative RRI, decline of RRI, and renal parenchyma to hydronephrosis area ratio (PHAR) as independent predictors of renal function recoverability after pyeloplasty. However, preoperative RRI and RRI decline were not significantly associated with recoverability of renal function in patients aged >35 years. Lower preoperative RRI, greater decline in RRI, higher PHAR, lower SFU grade, and extrarenal pelvis were associated with greater improvements in postoperative renal function. Conclusions: Preoperative differential renal function cannot independently predict the recoverability of postoperative renal function in adult patients with unilateral renal obstruction-induced hydronephrosis. SFU grade, renal pelvic type, PHAR, preoperative RRI, and decline in RRI were significantly associated with the recoverability of renal function in adult patients aged <35 years, while only SFU grade, renal pelvic type, and PHAR were significantly associated with renal function recoverability in patients aged ≥35 years. Renal function recovery was better in patients younger than 35 years when compared with older patients.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Predictors of Recoverability of Renal Function after Pyeloplasty in Adults with Ureteropelvic Junction Obstruction

Wu¹,

Wei²,

Chen³

et al. 2018

Urol Int

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“…Actuellement, on considère qu'un rein peut-être conservé si sa valeur fonctionnelle relative est supérieure à 10%, voire moins selon les travaux de Aziz et al; car de fait, il n'existe pas de corrélation entre l'importance de la dilatation et le degré d'obstruction [8,9]. Ainsi, une cure chirurgicale de désobstruction, type pyéloplastie, peut être envisagée pour les hydronéphrose géantes sur SJPU.…”

Section: Discussionunclassified

Hydronéphrose géante sur rein ectopique pelvien révélée par un syndrome occlusif: Cas rare.

Yassine¹

2014

African Journal of Urology

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“…40 Ponekad je pre nefrektomije potrebno postaviti perkutanu nefrostomu i posmatrati ponašanje parenhima nakon uklanjanja opstrukcije. 40,58 Nefrektomija se predlaže i u slučajevima često ponavljanih epizoda urinarne infekcije kod izražene hidronefroze, u slučajevima multiple kalkuloze i u slučajevima hipertenzije.…”

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Hidronefroza - procena stanja bubreznog parenhima

Kovacic¹

2017

Med gl Spec Bol Zlatibor

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UVODHidronefroza je proširenje bubrežne karlice i bubrežnih čašica zbog zastoja mokraće, koji nastaje usled mehaničkih ili dinamičkih poremećaja njene evakuacije kroz pijeloureteralni segment. 3Restrikcija urinarnog protoka, ukoliko se ne leči dovešće do progresivne atrofije i destrukcije parenhima bubrega. 24U kliničkoj praksi je cilj postaviti dijagnozu opstrukcije pre nego što dođe do oštećenja parenhima i podatak o funkcionalnom stanju bubrežnog parenhima ključni je faktor za odluku o daljem lečenju.U dijagnostici bubrežnih oboljenja metode tzv. medicinskih snimanja imaju veoma značajno mesto. Pod medicinskim snimanjima podrazumevamo metode rendgenske dijagnostike, metode nuklearne medicine, ultrazvuka i u najnovije vreme magnetne rezonance.Među svim ovim metodama ultrazvučna dijagnostika danas ima najširu primenu, prvenstveno zato što su pregledi ultrazvukom najmanje agresivni, najjeftiniji, najšire primenljivi, gotovo bez kontraidikacija. Ne zavise od funkcije bubrega i pored bubrega mogu da pruže informacije i o mnogim drugim susednim tkivima i organima.Ultrazvučnim pregledom se jednostavno dijagnostikuje dilatacija sabirnog sistema i u isto vreme se vizualizuje bubrežni parenhim.Merenjem maksimalnog dijametra bubrežne karlice na transverzalnom preseku, određuje se stepen hidronefroze. Ultrazvukom se takođe vizualizuje dilatacija bubrežnih čašica, veličina bubrega i ehogenost parenhima. Ultrazvuk pruža odlične anatomske detalje, bez izlaganja jonizujućem zračenju ili kontrastnim sredstvima, ali je ograničen u proceni bubrežne funkcije.Za procenu funkcije bubrega i urinarnog trakta potrebna je komplementarna radionuklidna metoda. Rad uže specijalizacije iz ultrazvuka u kliničkoj medicini, odbranjen na Medicinskom fakultetu u Beogradu, objavljujemo u skraćenom obimu.

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In Hydronephrosis Less than 10 % Kidney Function is not an Indication for Nephrectomy in Children

Cited by 44 publications

References 5 publications

Predictors of Recoverability of Renal Function after Pyeloplasty in Adults with Ureteropelvic Junction Obstruction

Predictors of Recoverability of Renal Function after Pyeloplasty in Adults with Ureteropelvic Junction Obstruction

Hydronéphrose géante sur rein ectopique pelvien révélée par un syndrome occlusif: Cas rare.

Hidronefroza - procena stanja bubreznog parenhima

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