The Postnatal Management of Hydronephrosis Diagnosed by Prenatal Ultrasound

Ransley, Philip G.; Dhillon, H.K.; Gordon, Isky; Duffy, P.G.; Dillon, M J; Barratt, T. M.

doi:10.1016/s0022-5347(17)39528-9

Cited by 446 publications

(184 citation statements)

References 9 publications

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“…The postnatal treatment of children with prenatally diagnosed hydronephrosis remains controversial in terms of the optimal timing of surgery, the ability to define which kidney will benefit from surgical intervention and which children will have a deterioration in renal function under surveillance [3][4][5][6][7][8][9][10]. The recovery of kidney function after either surgery or conservative management is the main issue in the treatment of patients with PUJ obstruction [6][7][8][9]15,16].…”

Section: Discussionmentioning

confidence: 99%

“…Maternal ultrasonography detects fetal hydronephrosis, leading to the diagnosis of PUJ obstruction postnatally in 0.2-0.4% of cases [1][2][3][4][5]; PUJ obstruction requires surgery in 15-30% of affected children [6][7][8][9][10][11][12][13][14]. Controversy continues on the optimal timing of the surgical correction in these children with antenatally detected hydronephrosis [7,8,[14][15][16][17].…”

Section: Introductionmentioning

confidence: 99%

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Does delaying pyeloplasty affect renal function in children with a prenatal diagnosis of pelvi‐ureteric junction obstruction?

et al. 2002

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Does delaying pyeloplasty affect renal function in children with a prenatal diagnosis of pelvi‐ureteric junction obstruction?

et al. 2002

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“…However, in their report, only 10 of 35 patients presented with a T 1/2 of >20 min and therefore the proportion of patients who will require surgery for symptoms or UTI in the future remains uncertain. Ransley et al [5] also assessed neonatal hydronephrosis but they did not always focus on the diuretic renogram. Patients with a clearly obstructed pattern on an initial scan are more likely to have poor ®nal renal function and less likely to become normal, with a signi®cant risk of renal impairment, despite close monitoring [9±11].…”

Section: Discussionmentioning

confidence: 99%

Calyx to parenchyma ratio in pelvi-ureteric junction obstruction

Imaji¹,

Dewan²

2002

BJU Int

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Objective To review the ultrasonography of patients who had undergone pyeloplasty for pelvi-ureteric junction (PUJ) obstruction, and document the changes in calyceal distension and parenchymal thickness after pyeloplasty, to attempt to establish an additional prognostic indicator. Patients and methods Fifty-eight patients who underwent pyeloplasty for PUJ obstruction were assessed retrospectively. Pre-and postoperative ultrasonograms were analysed for both pyelocaliectasis, graded according to the Society for Fetal Urology criteria, and the ratio of the depth of calyces to the thickness of the parenchyma (C/P ratio). Patients underwent nuclear medicine renography before and 3 months after pyeloplasty. The results were analysed using the paired t-test, Kruskal±Wallis test, Spearman's correlation coef®cient by rank test and the MannWhitney U-test. Results There was no signi®cant difference in hydronephrosis grade before and after surgery (P<0.05) but there was a signi®cant difference in the C/P ratios (P<0.01). There was no correlation between C/P ratios and the results of diuresis renography. Conclusion Hydronephrosis as measured by an estimate of pelvic volume is an insensitive marker of improvement after pyeloplasty. Reduced calyceal distension correlates well with other favourable prognostic indicators. Therefore, the C/P ratio may be an additional indicator of the appropriateness of surgical intervention, and should be the subject of further study.

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“…17 USG and scintigraphy are major screening methods in diagnosing UPO, evaluating the patients after surgery, and monitoring patients who have not undergone a surgical operation yet. 18,19 Biochemical indicators such as TGF-b 1 and b 2 microglobulin, urine, and blood electrolytes are also utilized in diagnosing and monitoring UPO in the recent years. [20][21][22][23][24][25] Alfuzosin, one of the selective a 1 blockers, is a pharmacological agent used in prostate hypertrophy.…”

Section: Discussionmentioning

confidence: 99%

The effect of alfuzosin on renal resistive index, urinary electrolytes and β2 microglobulin levels and TGF β-1 levels of kidney tissue in rats with unilateral ureteropelvic junction obstruction

et al. 2016

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(2016) The effect of alfuzosin on renal resistive index, urinary electrolytes and β2 microglobulin levels and TGF β-1 levels of kidney tissue in rats with unilateral ureteropelvic junction obstruction, Renal Failure, Background: In this study, it was aimed to determine the effects of alfuzosin on experimentally generated unilateral partial ureteropelvic junction obstruction (UPO) in rats. Materials and methods: Thirty Long-Evans rats were randomly allocated into five groups. In control group (C), nothing was performed; in group Sham (S) only laparotomy was done; in Alfuzosin group (A) only alfuzosin was administered for two weeks (10 mg/kg/day p.o.) without any surgery; in UPO group, unilateral UP junction obstruction was produced; and in the Group UPT (ureteropelvic obstruction þ treatment), alfuzosin was administered for two weeks (10 mg/kg/day p.o.) in addition to UPO production. Renal pelvic anteroposterior diameters were determined with ultrasonography (USG) and renal arterial resistivity indexes by color Doppler USG. Urine was collected both at the beginning and at the end of the experiment for 24 h in all the groups and at the end of the experiment, blood samples were obtained. Blood and urine electrolytes and TGFb1, urine density, urine b 2 microglobulin levels were determined. Renal tissue samples harvested from all of the rats were histopathologically evaluated. Results were determined using one-way ANOVA t-test; p < 0.05 was accepted as significant. Results: Urine density in the UPT group was lower with respect to UPO group and blood electrolytes were preserved as close to normal (p < 0.05). In the UPT group, urine TGF-b1 and blood TGFb1, blood b 2 microglobulin levels and histopathologic damage scores were lower compared to the UPO group (p < 0.05). Conclusion: It is shown in this experimental unilateral partial UPO model that alfuzosin treatment prevents obstructive renal damage.

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The Postnatal Management of Hydronephrosis Diagnosed by Prenatal Ultrasound

Cited by 446 publications

References 9 publications

Does delaying pyeloplasty affect renal function in children with a prenatal diagnosis of pelvi‐ureteric junction obstruction?

Does delaying pyeloplasty affect renal function in children with a prenatal diagnosis of pelvi‐ureteric junction obstruction?

Calyx to parenchyma ratio in pelvi-ureteric junction obstruction

The effect of alfuzosin on renal resistive index, urinary electrolytes and β2 microglobulin levels and TGF β-1 levels of kidney tissue in rats with unilateral ureteropelvic junction obstruction

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