Affiliation:
1. Pediatric Nephrology, Ankara University Faculty of Medicine, Ankara,
Turkey
2. Pediatric Urology, Ankara University Faculty of Medicine, Ankara,
Turkey
Abstract
Abstract
Backgound The aim of this study is to examine the long-term prognosis of
children with ureteropelvic junction obstruction-like hydronephrosis (UPJO-like
HN).
Patients and Methods The files of children with hydronephrosis (HN) were
analyzed retrospectively. Patients with vesicoureteral reflux (VUR) and other
genitourinary anomalies were excluded. The final status of the HN, the need for
surgery, and urinary tract infection (UTI) frequency were evaluated.
Results The study included 219 patients with 302 renal units (RU) with HN.
Surgery rate was higher in RUs with larger kidney size and parenchymal thinning
(p:<0.001 for both). Hydronephrosis resolved in 113 (40.2%) RUs,
improved in 66 (23.3%), unchanged in 100 (35.5%) and worsened in
4 (1.4%). The frequency of recovery and improvement was found to be less
in RUs with severe HN, large kidney size, and thin parenchyma. The UTI frequency
was higher in severe HN group (12.2% vs 30.6%
p:<0.001).
Conclusions Children with mild HN had an excellent prognosis. Although the
majority of the patients with high-grade HN had also a good prognosis, it seems
important to closely follow up patients with severe HN, increased kidney size,
and accompanying parenchymal thinning. Clinicians should be aware of the
increased frequency of UTIs in children with severe HN.
Subject
Pediatrics, Perinatology and Child Health