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HYDRONEPHROSIS WITH DIFFUSE OR SEGMENTAL CORTICAL THINNING: IMPACT ON RENAL FUNCTION

2001; Lippincott Williams & Wilkins; Volume: 165; Issue: 6 Part 2 Linguagem: Inglês

10.1016/s0022-5347(05)66187-3

1527-3792

H. Sibai, João L. Pippi Salle, Anne‐Marie Houle, R Lambert,

Kidney Stones and Urolithiasis Treatments

No AccessJournal of UrologyObstruction1 Jun 2001HYDRONEPHROSIS WITH DIFFUSE OR SEGMENTAL CORTICAL THINNING: IMPACT ON RENAL FUNCTION H. SIBAI, J.L. PIPPI SALLE, A.M. HOULE, and R. LAMBERT H. SIBAIH. SIBAI More articles by this author , J.L. PIPPI SALLEJ.L. PIPPI SALLE More articles by this author , A.M. HOULEA.M. HOULE More articles by this author , and R. LAMBERTR. LAMBERT More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)66187-3AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Management of hydronephrosis has changed considerably with the routine use of prenatal ultrasonography. Increased dependence is now placed on nuclear renographic differential renal function, and many urologists consider surgical intervention for ureteropelvic junction obstruction with significant decrease in renal function (less than 40%). Correlation between differential renal function and the degree of dilatation diagnosed by ultrasound has not been reported. In addition, no difference between hydronephrosis associated with either diffuse or segmental cortical thinning has been made, as both are classified as grade IV according to the Society of Fetal Urology classification. Based on clinical observation we hypothesized that hydronephrotic grade IV kidneys with diffuse parenchymal thinning are associated with worse renal function and are distinct from those with segmental cortical thinning. Materials and Methods: We performed a retrospective study of patients who underwent pyeloplasty between January 1996 and December 1998. Hydronephrosis was graded according to Society for Fetal Urology classification and all diuretic renograms were performed in a standardized fashion. Grade IV kidneys were divided into IVA (segmental cortical thinning) and IVB (diffuse cortical thinning). Statistical correlation of grade and differential renal function was performed using a chi-square test. Results: Images were available for review in 77 patients. Average patient age at intervention was 20.4 months and 7.6 years of the prenatally and postnatally detected hydronephrosis groups, respectively. Of the 77 cases 25 had grade IVA and 18 had grade IVB hydronephrosis. Of the grade IVB hydronephrosis cases 66% had less than 40% differential renal function compared to 24% in group IVA (p <0.05). Conclusions: Patients with grade IVB hydronephrosis secondary to ureteropelvic junction obstruction have a higher risk of significant decrease in renal function. Group IVA has significantly better function than group IVB and characteristics similar to grade III hydronephrosis cases. Grade IVB hydronephrosis should monitorized closely as earlier intervention may be warranted to avoid progressive deterioration of renal function. 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Link, Google Scholar From the Divisions of Urology and Nuclear Medicine, The Montreal Children’s Hospital and Hôpital Sainte Justine, Montreal, Quebec, Canada© 2001 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byHodhod A, Capolicchio J, Jednak R, El-Sherif E, El-Doray A and El-Sherbiny M (2018) Evaluation of Urinary Tract Dilation Classification System for Grading Postnatal HydronephrosisJournal of Urology, VOL. 195, NO. 3, (725-730), Online publication date: 1-Mar-2016.Keays M, Guerra L, Mihill J, Raju G, Al-Asheeri N, Geier P, Gaboury I, Matzinger M, Pike J and Leonard M (2008) Reliability Assessment of Society for Fetal Urology Ultrasound Grading System for HydronephrosisJournal of Urology, VOL. 180, NO. 4S, (1680-1683), Online publication date: 1-Oct-2008.Konda R, Sakai K, Ota S, Abe Y, Hatakeyama T and Orikasa S (2018) Ultrasound Grade of Hydronephrosis and Severity of Renal Cortical Damage on 99mTechnetium Dimercaptosuccinic Acid Renal Scan in Infants With Unilateral Hydronephrosis During Followup and After PyeloplastyJournal of Urology, VOL. 167, NO. 5, (2159-2163), Online publication date: 1-May-2002. Volume 165Issue 6 Part 2June 2001Page: 2293-2295 Advertisement Copyright & Permissions© 2001 by American Urological Association, Inc.KeywordsabnormalitieskidneyhydronephrosisMetricsAuthor Information H. SIBAI More articles by this author J.L. PIPPI SALLE More articles by this author A.M. HOULE More articles by this author R. LAMBERT More articles by this author Expand All Advertisement PDF downloadLoading ...