Predictive value of cortical transit time on MAG3 for surgery in antenatally detected unilateral hydronephrosis caused by ureteropelvic junction stenosis

Lee, Jun Nyung; Kang, Jun-Koo; Jeong, Shin Young; Lee, So Mi; Cho, Min Hyun; Ha, Yun‐Sok; Kim, Hyun Tae; Kim, Tae‐Hwan; Yoo, Eun Sang; Kwon, Tae Gyun; Chung, Sung Kwang

doi:10.1016/j.jpurol.2017.08.009

Cited by 17 publications

(12 citation statements)

References 17 publications

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“…Ureteral duplicity is confirmed by the identification of two collecting systems at the level of a single kidney. The most effective examinations in this detection are intravenous urogram (IVU) or intravenous pyelogram (IVP), computed tomography (CT) of the kidneys and magnetic resonance imaging (MRI) [5][6][7]. In the case of our patient, the computed tomography (CT) of the kidneys performed did not contribute very significantly.…”

Section: Discussionmentioning

confidence: 82%

A Child with Right Complete Ureteral Duplication Revealed by Sepsis in Northern Benin: A Case Report

Agossou

Gandaho

et al. 2020

Asp Biomed Clin Case Rep

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Upper urinary tract abnormalities are relatively common and may be diagnosed before or at birth. Some cases will be seen during complications that most often are obstructive. We herein report one case of complete right ureter duplication revealed by sepsis. The case involved one little girl aged 3 years, referred from a peripheral health center for prolonged fever. Physical examination found out a right flank mass connecting with the lumbar spine, renal ballottement, and pain due to a blow to the right flank. Further explorations helped establish the diagnosis of complete duplication of the right ureter with the destruction of the upper renal pelvis. Little girl benefitted from a dual antibiotic therapy combined with partial nephrectomy of the right kidney upper pole. Infectious are serious complications in upper urinary tract obstructions resulting in kidney destruction; therefore, early diagnosis is required.

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Section: Discussionmentioning

confidence: 82%

A Child with Right Complete Ureteral Duplication Revealed by Sepsis in Northern Benin: A Case Report

Agossou

Gandaho

et al. 2020

Asp Biomed Clin Case Rep

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“…An absence of well-controlled prospective studies in this field is partly responsible for this situation [22,23]. The searches for early predictors of renal function deterioration have shown that increased cortical transit time on MAG3 renal scans (more than 3 min) can be a promising early predictor of ongoing obstruction, renal function deterioration and surgery [24]. However, this method supposes radiation exposure, often requires sedation for children and is more expensive and less available in small centers and ambulatory settings.…”

Section: Discussionmentioning

confidence: 99%

Diuretic Enhanced Ultrasonography in the Diagnosis of Pyeloureteral Obstruction

et al. 2019

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Background and Objectives: To determine the value of diuretic ultrasonography for the diagnosis of obstructive hydronephrosis. Materials and Methods: Diuretic enhanced ultrasonography was used routinely as a part of examination of patients with hydronephrosis in our Department. There were 72 patients (42 males, 30 females; aged 2 months to 17 years; median age 7.07 years) with a sonoscopic diagnosis of hydronephrosis included from January 2006 until October 2011. The anteroposterior diameter (AD) of renal pelvis was measured sonoscopically before and at sixty minutes after furosemide injection. A weight-adjusted dose of 1 mg/kg of furosemide was administered intravenously. Results: Patients were operated on if pyeloureteral obstruction was suspected because of low or deteriorating differential renal function, increasing hydronephrosis or symptoms thereof. Hydronephrosis was unilateral in 61 (84.7%) and bilateral in 11 (15.3%) patients. The median AD of pelvis before furosemide injection was 22 mm in operated and 17 mm in non-operated patients (p = 0.005). Sixty minutes after furosemide injection, the AD of pelvis in operated patients was 35.5 mm and 25.8 mm in non-operated—25.8 mm (p < 0.001). Logistic regression model demonstrated that significant factors for surgery were: AD 60 min after furosemide infection and ultrasonographic parenchymal sclerosis. Conclusion: Ultrasound measurement of the AD of renal pelvis 1 h after the injection of furosemide used as an additional investigation can help in predicting obstructive hydronephrosis.

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“…Song et al demonstrated that children with delayed cortical transit time had greater improvement of their DRU after surgery compared to those with normal values (32). Furthermore, a delayed transit time has been shown to be a prognostic factor identifying which children will progress to surgery while on observation (33,34). Interestingly, in a porcine model, delayed cortical transit time has been linked to histological changes such as glomerulosclerosis, decreased number of glomeruli, tubular atrophy, and increased fibrosis (35).…”

Section: Diuretic Nephrographymentioning

confidence: 99%

Managing Ureteropelvic Junction Obstruction in the Young Infant

Passoni

Peters

2020

Front. Pediatr.

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In the last decade, management of congenital UPJ obstruction has become progressively observational despite the lack of precise predictors of outcome. While it is clear that many children will have resolution of their hydronephrosis and healthy kidneys, it is equally clear that there are those in whom renal functional development is at risk. Surgical intervention for the young infant, under 6 months, has become relatively infrequent, yet can be necessary and poses unique challenges. This review will address the clinical evaluation of UPJO in the very young infant and approaches to determining in whom surgical intervention may be preferable, as well as surgical considerations for the small infant. There are some clinical scenarios where the need for intervention is readily apparent, such as the solitary kidney or in child with infection. In others, a careful evaluation and discussion with the family must be undertaken to identify the most appropriate course of care. Further, while minimally invasive pyeloplasty has become commonly performed, it is often withheld from those under 6 months. This review will discuss the key elements of that practice and offer a perspective of where minimally invasive pyeloplasty is of value in the small infant. The modern pediatric urologist must be aware of the various possible clinical situations that may be present with UPJO and feel comfortable in their decision-making and surgical care. Simply delaying an intervention until a child is bigger may not always be the best approach.

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Predictive value of cortical transit time on MAG3 for surgery in antenatally detected unilateral hydronephrosis caused by ureteropelvic junction stenosis

Cited by 17 publications

References 17 publications

A Child with Right Complete Ureteral Duplication Revealed by Sepsis in Northern Benin: A Case Report

A Child with Right Complete Ureteral Duplication Revealed by Sepsis in Northern Benin: A Case Report

Diuretic Enhanced Ultrasonography in the Diagnosis of Pyeloureteral Obstruction

Managing Ureteropelvic Junction Obstruction in the Young Infant

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