Outcome of patients with antenatally detected pelviureteric junction obstruction

Ylinen, Elisa; Ala‐Houhala, Marja; Wikström, Sakari

doi:10.1007/s00467-004-1498-9

Cited by 31 publications

(26 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Cornford and Rickwood [20] also reported that pyeloplasty failed to significantly improve renal function in patients born with UPJO and impaired renal function. Ylinen et al [23] found that in the group with early surgery, the primarily normal function remained unchanged, but in kidneys with poor function, recovery may be minimal despite pyeloplasty. Research on animal models has also confirmed that removal of obstruction did not reverse renal injury, mainly because of the progression of fibrosis [24].…”

Section: Discussionmentioning

confidence: 96%

Long-term follow-up and management of prenatally detected, isolated hydronephrosis

Yang

Hou

Niu

et al. 2010

Journal of Pediatric Surgery

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 96%

Long-term follow-up and management of prenatally detected, isolated hydronephrosis

Yang

Hou

Niu

et al. 2010

Journal of Pediatric Surgery

View full text Add to dashboard Cite

“…Most kidneys in each functional range improved when obstruction was relieved. Arelative renal flow > 51% in the obstructed kidney by 99m technetium mercaptoacetyl triglycine study was not always beneficialin prognosticating, and may be a warning of impending decompensation in a minority [18,19].…”

Section: Prognosismentioning

confidence: 90%

Profile and Outcome of Pelviureteric Junction Obstruction

Senguttuvan

Jigy²

2014

TOUNJ

View full text Add to dashboard Cite

Abstract:Obstructive uropathy represents one of the largest fractions of identifiable causes of renal failure in pediatric populations. This is one of the largest series of PUJ obstructions reported in children. PUJ obstruction is a relatively common congenital anamolyes in neonates and children and a cause of ESRD in developing countries. This series expands our knowledge about the clinical presentation and course of this disease. Pelviureteric junction (PUJ) obstruction is a partial or total blockage of the flow of urine that occurs where the ureter enters the kidney and is the most common cause of significant dilatation of the collecting system in the fetal kidney. We retrospectively analyzed children diagnosed as PUJ obstruction between the periods of 2008-2010 who presented to our institute. Forty four children were diagnosed to have PUJ obstruction. The median age at presentation was 11 months, with range of 3 months to 11 years. Male children constituted 34 (77.3%) cases. Unilateral PUJ with left sided involvement was more common (52.3%). Antenatal diagnosis was made in 18 (40.9%) cases. The common clinical presentations were fever, urinary tract infection (UTI) and abdominal pain. Hypertension was present in five (11.3%) patients and renal failure at presentation was seen in eight (18.2%) patients. Associated urogenital anomalies were present in twelve (27.3%) patients, with medullary cystic kidney disease (MCKD) being the most commonassociated anomaly. Prophylactic antibiotics were not prescribed to patients. Urinary tract infection was present in fourteen (31.9%) patients with E. coli being the most common organism (75%). Conservative management with regular follow up was done for 32 patients and the remaining twelve patients underwent pyeloplastyin view of gross hydronephrosis, and four (33.3%)of these patients later underwent nephrectomy for a nonfunctioning kidney. Antenatal screening is mandatory to make an early diagnosis and for further management and close follow upof PUJ obstruction. Randomized control trials and longer follow up studies are needed for evidence to suggest the optimal management.

show abstract

“…7 In terms of initially poor functioning kidney, congenital damage may influence recoverability of the affected kidney. In a recent study Ylinen et al 18 reported that no improvement occurred in the kidney with <30% preoperative DRF regardless of successful surgical correction. Although Ulman et al 5 described in some children renal function may take years to improve to > 40%, our data did not support their findings.…”

Section: Discussionmentioning

confidence: 99%

Delayed decrease in differential renal function after successful pyeloplasty in children with unilateral antenatally detected hydronephrosis

et al. 2007

View full text Add to dashboard Cite

Aim:The aim of this study was to evaluate functional outcome of congenital hydronephrotic kidney. Methods: The records of consecutive children who underwent pyeloplasty for unilateral prenatally detected ureteropelvic junction obstruction were reviewed. Renal function was assessed renographically before and after surgery. Mean follow-up period was 100 months. Results: Sufficient pre-and postoperative data were available for 60 children. Differential renal function (DRF) improved in 14 (23%) and decreased in nine (15%) of 60 patients in the early postoperative period. DRF improved in seven (18%) and decreased in 13 (34%) of 38 patients at the end of follow-up. Five of 14 patients with increased DRF at early postoperative scan returned to the preoperative level at the end of follow-up. No patients with decreased DRF at early postoperative scan showed any recovery in DRF and progressive decrease was seen in four of nine children. Conclusions:The DRF was not stable in some patients after successful pyeloplasty. In some patients impairment of renal function came to be apparent with time. Improvement of DRF may be a transient phenomenon seen in the early postoperative period. To avoid overestimation of functional recovery, long-term follow-up with delayed renographic evaluation is recommended.

show abstract

Outcome of patients with antenatally detected pelviureteric junction obstruction

Cited by 31 publications

References 32 publications

Long-term follow-up and management of prenatally detected, isolated hydronephrosis

Long-term follow-up and management of prenatally detected, isolated hydronephrosis

Profile and Outcome of Pelviureteric Junction Obstruction

Delayed decrease in differential renal function after successful pyeloplasty in children with unilateral antenatally detected hydronephrosis

Contact Info

Product

Resources

About