Observation of infants with SFU Grades 3–4 hydronephrosis: Worsening drainage with serial diuresis renography indicates surgical intervention and helps prevent loss of renal function

Ross, Scott E.; Kardos, Steve; Krill, Aaron; Bourland, Jason; Sprague, Bruce M.; Majd, Massoud; Pohl, Hans G.; Gibbons, M. David; Belman, A. Barry; Rushton, H. Gil

doi:10.1016/j.jpurol.2011.03.001

Cited by 55 publications

(26 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Only 44% of kidneys with grade 4 HN and 4% of grade 3 HN underwent early surgery for high-grade obstruction. 13 In contrast, Chertin et al have shown that 50% of children followed conservatively went on to surgery. 14 However, one must recognize that the criteria for surgical intervention are variable and may be affected by the surgeons' and parents' wishes.…”

Section: Discussionmentioning

confidence: 97%

Prenatally detected, unilateral, high-grade hydronephrosis: Can we predict the natural history?

Sarhan

Helaly

Otay

et al. 2017

CUAJ

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 97%

Prenatally detected, unilateral, high-grade hydronephrosis: Can we predict the natural history?

Sarhan

Helaly

Otay

et al. 2017

CUAJ

View full text Add to dashboard Cite

show abstract

“…In recent years, surgical intervention is accepted as a common management when the deterioration of hydronephrosis in unilateral UPJO occurs and when the split function in diuretic scintigraphy is below 40% [14,24,28]. However, in cases like ours especially with bilateral stasis, although the functions decrease, the DRF symmetry does not change.…”

Section: Discussionmentioning

confidence: 99%

Comparison of two different periods of renal cortical activity ratios in the evaluation of ureteropelvic junction obstruction by dynamic renal scintigraphy

Hasbek¹,

Özdemir²,

Turgut³

et al. 2014

CMJ

View full text Add to dashboard Cite

Aim. The aim of this retrospective study is to investigate whether the renal cortical activity at 1st and 20th minutes in renal scintigraphy can be used as a following parameter to determine the presence of obstruction in pediatric patients group with ureteropelvic junction obstruction. Method. The consecutive 322 kidney renograms were included in the study. Standardized diuretic renograms were visually classified into three groups as non-obstructive, obstructive and indetermined according to their responses to the diuretic. In addition, the cortical regions of interest (ROI) were drawn manually at 1st and 20th min for each kidney and the cortical counts were obtained. Apart from this, kidneys were divided into three major sub-groups based on clearance half-time (T1/2); T1/2<10 min was defined as non-obstruction, T1/2>20 min as obstruction and T1/2 with a value between 10 and 20 minutes as an indeterminate result. Afterwards visual obstruction patterns and 1st/20th min. cortical activity ratios were compared. Results. When the cortical activity ratios are compared to visual obstructive pattern(nonobstructive, obstructive and indeterminate); on the Tc99m DTPA renograms the cortical activity ratios which were greater than 82.8% were obstructive, ranging from 59.3% to 82.8% were found indeterminate. On the Tc-99m MAG-3 renograms the cortical activity ratios which were greater than 74.2% were obstructive, ranging from 44.6% to74.2% were found indeterminate. As a result of the comparison of T 1/2 parameter with the obstruction patterns of the kidneys, T1/2 was in indeterminate group in 124 (41.5%) out of 299 kidneys visually evaluated as non-obstructive while in 7 (2.3%) kidneys T1/2 was in obstructive group. In 4 (23.5%) out of 17 kidneys which were visually evaluated as indeterminate, T 1/2 was in normal group, in 5 (29.4%) of them T 1/2 was in indeterminate group and in 8 (47.1%) of the 17 kidneys T1/2 was in obstructive group. Conclusion. We think that the use of 1st/20th min. cortical activity ratios on the diuretic renogram are helpful in establishing a diagnosis of obstruction in pediatric patient group.

show abstract

“…A prospective study with a large numbers of patients followed with conservative treatment showed the need for conversion to surgical treatment in 22% of patients during a followup period of 10 years 6 . By adopting similar approach, our study…”

Section: Discussionmentioning

confidence: 99%

“…Currently, the diagnose of urinary tract obstruction in children is made by demonstration of hydronephrosis associated with progressive reduction of renal function assessed by radioisotopes 4,5 . The analysis of sequential images obtained by ultrasound associated with scintigraphic assessment of renal function provides objective tools that helps in the decision make to opt for clinical observation or surgery in those children whose hydronephrosis persists in the post-natal life 6 .…”

Section: Introductionmentioning

confidence: 99%

Postnatal evaluation of intrauterine hydronephrosis due to ureteropelvic junction obstruction

et al. 2013

View full text Add to dashboard Cite

PURPOSE:Fetal hydronephrosis is a frequent finding due to advances in prenatal ultrasonography. The definition of fetal and neonatal urinary tract obstruction is a very difficult task requiring confirmation of reduced renal function and hydronephrosis. In this study we followed a series of consecutive patients with intrauterine hydronephrosis that persisted during post-natal life. METHODS:116 newborns with antenatal hydronephrosis diagnosed by ultrasound and submitted to a specific post-natal evaluative protocol with a follow-up period of 6 years. RESULTS:In 45 (38.8%) of 116 patients, ureteropelvic junction (UPJ) obstruction was confirmed and surgical correction of the UPJ obstruction was done in 19 patients. From 26 children who were initially submitted to non-surgical treatment, only 6 (23%) needed a surgical approach during follow up. Overall analysis showed that surgery was performed in 25 patients with UPJ obstruction, and the others 20 patients were kept under clinical observation, since normal renal function was confirmed by scintigraphy scans. CONCLUSION:Fetal hydronephrosis due to UPJ obstruction deserves careful postnatal evaluation. UPJ obstruction is the most frequent anomaly and its surgical treatment has very precise indications. The evaluative protocol was useful in identify patients that could be followed-up with a non-surgical approach.Key words: Hydronephrosis. Prenatal Diagnosis. Radionuclide Imaging. RESUMO OBJETIVO:Com a ampla utilização dos exames ultrassonográficos na avaliação pré-natal, é frequente o diagnóstico da hidronefrose fetal. A definição de obstrução do trato urinário no periodo pós-natal necessita da confirmação de redução da função renal além da hidronefrose. Neste estudo, acompanhamos uma série de pacientes consecutivos com hidronefrose intra-útero que persistiu no periodo pós-natal. MÉTODOS:116 recém-nascidos com hidronefrose pré-natal diagnosticada pela ultrassonografia foram submetidos a protocolo específico de avaliação e companhados pelo periodo de 06 anos. inicialmente para observação clínica, apenas 6 (23%) necessitaram cirurgia durante o seguimento ambulatorial. Na análise geral, o procedimento cirúrgico para correção da estenose da JUP foi indicado em 25 pacientes. Nas outras 20 crianças não houve necessidade da realização da cirurgia. RESULTADOS:CONCLUSÃO: a hidronefrose fetal requer cuidadosa avaliação pós-natal. A estenose da junção pielo-ureteral é a anomalia mais frequente como causa da hidronefrose, e sua correção cirúrgica tem indicações precisas. O protocolo aplicado foi útil em diferenciar pacientes que não necessitaram cirurgia para tratamento da estenose da JUP. Descritores:Hidronefrose. Diagnóstico Pré-natal. Cintilografia.

show abstract

Observation of infants with SFU Grades 3–4 hydronephrosis: Worsening drainage with serial diuresis renography indicates surgical intervention and helps prevent loss of renal function

Cited by 55 publications

References 7 publications

Prenatally detected, unilateral, high-grade hydronephrosis: Can we predict the natural history?

Prenatally detected, unilateral, high-grade hydronephrosis: Can we predict the natural history?

Comparison of two different periods of renal cortical activity ratios in the evaluation of ureteropelvic junction obstruction by dynamic renal scintigraphy

Postnatal evaluation of intrauterine hydronephrosis due to ureteropelvic junction obstruction

Contact Info

Product

Resources

About