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1 year follow-up results of prenatally diagnosed unilateral hydronephrosis according to renal sonographic findings at 1 month of age  

Yoon, Hoe-Soo (Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine)
Yum, Mi Sun (Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine)
Lee, Joo Hoon (Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine)
Park, Young Seo (Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine)
Kim, Kun Seok (Department of Urology, Asan Medical Center, University of Ulsan College of Medicine)
Yoon, Chong Hyun (Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine)
Moon, Dae Hyuk (Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine)
Hahn, Hyewon (Department of Pediatrics, Eulji University School of Medicine)
Publication Information
Clinical and Experimental Pediatrics / v.49, no.1, 2006 , pp. 64-70 More about this Journal
Abstract
Purpose : The natural courses of prenatally diagnosed hydronephrosis(HN) are diverse. Our purpose was to determine if the findings of renal ultrasonography(USG) in patients with prenatal HN at 1 month of age can predict the 1 year follow-up results and determine the guideline of follow-up study. Methods : Among 462 hydronephrotic patients registered between 1996 and 2004, 153 unilateral hydronephrotic renal units were enrolled in this study, bilateral HN, vesicoureteral reflux and other associated anomaly were excluded. These were classified into four groups respectively, according to anterior posterior pelvic diameter(APPD) or Society for Fetal Urology(SFU) grading by USG findings at 1 month after birth. Renal USG and $Tc^{99m}$-mercaptoacetyl triglycerine(MAG3) scan were done according to a set protocol. Results : Most cases improved or remained stationary. No one underwent an operation SFU grade 1,2 groups and only one case of SFU grade 3 group was operated. Thirty two cases(64 percent) were operated on among the 50 cases of SFU grade 4 group. 0/2(0 percent), 5/11(45.5 percent), 11/17(64.7 percent) and 16/20(80 percent) were operated on in each group with APPD <10, 10-19, 20-29, >30 mm, and the operation risk is higher as the APPD is increased. Conclusion : In group with SFU grade below 3 and APPD below 10 mm, we can delay the follow-up study beyond existing set protocol. Operations are recommended immediately if diuretic renogram show the obstructive pattern or decreased renal function in SFU grade 4 group with APPD over 10 mm.
Keywords
Hydronephrosis; Anterior posterior pelvic diameter(APPD); Society for fetal urology(SFU) grade; Renal ultrasonography(USG);
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Times Cited By KSCI : 2  (Citation Analysis)
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