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Diagnostic accuracy of neonatal kidney ultrasound in children having antenatal hydronephrosis without ureter and bladder abnormalities

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Abstract

Purpose

To determine the diagnostic accuracy of anteroposterior renal pelvic diameter (APD) measurement and the society for fetal urology (SFU) grading in neonatal ultrasonography (USG) for detecting uropathy in newborns having antenatal isolated hydronephrosis (IH), characterized by hydronephrosis without ureter and bladder abnormalities, and to study time to resolution and factors predicting resolution of insignificant hydronephrosis.

Methods

Ninety-six healthy newborns (129 kidneys) with IH, who underwent USG at age 7–30 days and voiding cystourethrography (VCUG) in conjunction with diuretic renography (DR) if APD > 10 mm or SFU grade 3–4 in neonatal USG, and at least a 12-month follow-up were divided into significant and insignificant hydronephrosis using the combined data of sequential USG, VCUG, and DR as the reference standard.

Results

Areas under the receiver operating characteristic plots (95 % CI) were 0.86 (0.79–0.94) versus 0.81 (0.73–0.89); p = 0.08, and 87.6 versus 79.8 % of cases were correctly classified, for APD ≥ 16 mm versus SFU grade 4, respectively. Ureteropelvic junction obstruction (UPJO) was the most common uropathy diagnosed. Of 85 kidneys with insignificant hydronephrosis, 57 underwent spontaneous resolution. The resolution rates were 24, 40, and 68 % at age 6, 12, and 24 months, respectively. APD was the only independent factor predicting resolution with the hazard ratio of 0.83 (95 % CI 0.74–0.92; p = 0.001).

Conclusions

In IH, neonatal USG was a useful diagnostic tool to detect uropathy, mainly UPJO. Further investigation should be recommended when APD ≥ 16 mm or SFU grade 4.

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References

  1. Riccabona M (2004) Assessment and management of newborn hydronephrosis. World J Urol 22(2):73–78. doi:10.1007/s00345-004-0405-0

    PubMed  Google Scholar 

  2. Yiee JH, Tasian GE, Copp HL (2011) Management trends in prenatally detected hydronephrosis: national survey of pediatrician practice patterns and antibiotic use. Urology 78(4):895–901. doi:10.1016/j.urology.2011.04.027

    Article  PubMed Central  PubMed  Google Scholar 

  3. Braga LH, Ruzhynsky V, Pemberton J, Farrokhyar F, Demaria J, Lorenzo AJ (2014) Evaluating practice patterns in postnatal management of antenatal hydronephrosis: a national survey of Canadian pediatric urologists and nephrologists. Urology 83(4):909–914. doi:10.1016/j.urology.2013.10.054

    Article  PubMed  Google Scholar 

  4. Sidhu G, Beyene J, Rosenblum ND (2006) Outcome of isolated antenatal hydronephrosis: a systematic review and meta-analysis. Pediatr Nephrol 21(2):218–224. doi:10.1007/s00467-005-2100-9

    Article  PubMed  Google Scholar 

  5. Tombesi MM, Alconcher LF (2012) Short-term outcome of mild isolated antenatal hydronephrosis conservatively managed. J Pediatr Urol 8(2):129–133. doi:10.1016/j.jpurol.2011.06.009

    Article  PubMed  Google Scholar 

  6. Mami C, Paolata A, Palmara A, Marrone T, Berte LF, Marseglia L, Arena F, Manganaro R (2009) Outcome and management of isolated moderate renal pelvis dilatation detected at postnatal screening. Pediatr Nephrol 24(10):2005–2008. doi:10.1007/s00467-009-1229-3

    Article  PubMed  Google Scholar 

  7. Garne E, Loane M, Wellesley D, Barisic I (2009) Congenital hydronephrosis: prenatal diagnosis and epidemiology in Europe. J Pediatr Urol 5(1):47–52. doi:10.1016/j.jpurol.2008.08.010

    Article  PubMed  Google Scholar 

  8. Coplen DE, Austin PF, Yan Y, Blanco VM, Dicke JM (2006) The magnitude of fetal renal pelvic dilatation can identify obstructive postnatal hydronephrosis, and direct postnatal evaluation and management. J Urol 176(2):724–727. doi:10.1016/j.juro.2006.03.079 discussion 727

    Article  PubMed  Google Scholar 

  9. Passerotti CC, Kalish LA, Chow J, Passerotti AM, Recabal P, Cendron M, Lee RS, Lopez AB, Retik AB, Nguyen HT (2011) The predictive value of the first postnatal ultrasound in children with antenatal hydronephrosis. J Pediatr Urol 7(2):128–136. doi:10.1016/j.jpurol.2010.09.007

    Article  PubMed  Google Scholar 

  10. Onen A (2007) Treatment and outcome of prenatally detected newborn hydronephrosis. J Pediatr Urol 3(6):469–476. doi:10.1016/j.jpurol.2007.05.002

    Article  PubMed  Google Scholar 

  11. Hothi DK, Wade AS, Gilbert R, Winyard PJ (2009) Mild fetal renal pelvis dilatation: much ado about nothing? Clin J Am Soc Nephrol 4(1):168–177. doi:10.2215/CJN.00810208

    Article  PubMed Central  PubMed  Google Scholar 

  12. Davenport MT, Merguerian PA, Koyle M (2013) Antenatally diagnosed hydronephrosis: current postnatal management. Pediatr Surg Int 29(3):207–214. doi:10.1007/s00383-012-3258-4

    Article  PubMed  Google Scholar 

  13. Timberlake MD, Herndon CD (2013) Mild to moderate postnatal hydronephrosis–grading systems and management. Nat Rev Urol 10(11):649–656. doi:10.1038/nrurol.2013.172

    Article  PubMed  Google Scholar 

  14. Vemulakonda V, Yiee J, Wilcox DT (2014) Prenatal hydronephrosis: postnatal evaluation and management. Curr Urol Rep 15(8):430. doi:10.1007/s11934-014-0430-5

    Article  PubMed  Google Scholar 

  15. Lebowitz RL, Olbing H, Parkkulainen KV, Smellie JM, Tamminen-Mobius TE (1985) International system of radiographic grading of vesicoureteric reflux. International Reflux Study in Children. Pediatr Radiol 15(2):105–109

    Article  CAS  PubMed  Google Scholar 

  16. de Kort EH, Bambang Oetomo S, Zegers SH (2008) The long-term outcome of antenatal hydronephrosis up to 15 millimetres justifies a noninvasive postnatal follow-up. Acta Paediatr 97(6):708–713. doi:10.1111/j.1651-2227.2008.00749.x

    Article  PubMed  Google Scholar 

  17. Dias CS, Silva JM, Pereira AK, Marino VS, Silva LA, Coelho AM, Costa FP, Quirino IG, Simoes ESAC, Oliveira EA (2013) Diagnostic accuracy of renal pelvic dilatation for detecting surgically managed ureteropelvic junction obstruction. J Urol 190(2):661–666. doi:10.1016/j.juro.2013.02.014

    Article  PubMed  Google Scholar 

  18. Ismaili K, Avni FE, Wissing KM, Hall M (2004) Long-term clinical outcome of infants with mild and moderate fetal pyelectasis: validation of neonatal ultrasound as a screening tool to detect significant nephrouropathies. J Pediatr 144(6):759–765. doi:10.1016/j.jpeds.2004.02.035

    PubMed  Google Scholar 

  19. Dhillon HK (1998) Prenatally diagnosed hydronephrosis: the Great Ormond Street experience. Br J Urol 81(Suppl 2):39–44

    Article  PubMed  Google Scholar 

  20. Longpre M, Nguan A, Macneily AE, Afshar K (2012) Prediction of the outcome of antenatally diagnosed hydronephrosis: a multivariable analysis. J Pediatr Urol 8(2):135–139. doi:10.1016/j.jpurol.2011.05.013

    Article  PubMed  Google Scholar 

  21. St Aubin M, Willihnganz-Lawson K, Varda BK, Fine M, Adejoro O, Prosen T, Lewis JM, Shukla AR (2013) Society for fetal urology recommendations for postnatal evaluation of prenatal hydronephrosis—will fewer voiding cystourethrograms lead to more urinary tract infections? J Urol 190(4 Suppl):1456–1461. doi:10.1016/j.juro.2013.03.038

    Article  PubMed  Google Scholar 

  22. Estrada CR Jr (2008) Prenatal hydronephrosis: early evaluation. Curr Opin Urol 18(4):401–403. doi:10.1097/MOU.0b013e328302edfe

    Article  PubMed  Google Scholar 

  23. Pereira AK, Reis ZS, Bouzada MC, de Oliveira EA, Osanan G, Cabral AC (2011) Antenatal ultrasonographic anteroposterior renal pelvis diameter measurement: is it a reliable way of defining fetal hydronephrosis? Obstet Gynecol Int 2011:861865. doi:10.1155/2011/861865

    PubMed Central  PubMed  Google Scholar 

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical standard

The study was approved by the Institutional Review Board Committee of Faculty of Medicine, Chulalongkorn University, and has therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. Parents gave their informed consent prior to the inclusion in the study. Patient anonymity was preserved.

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Authors and Affiliations

  1. Division of Nephrology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, 1873 Rama 4 Road, Pathumwan, Bangkok, 10330, Thailand

    Pornpimol Rianthavorn

  2. Division of Nephrology, Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand

    Sorawan Limwattana

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  1. Pornpimol Rianthavorn
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  2. Sorawan Limwattana
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Correspondence to Pornpimol Rianthavorn.

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Rianthavorn, P., Limwattana, S. Diagnostic accuracy of neonatal kidney ultrasound in children having antenatal hydronephrosis without ureter and bladder abnormalities. World J Urol 33, 1645–1650 (2015). https://doi.org/10.1007/s00345-015-1478-7

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  • DOI: https://doi.org/10.1007/s00345-015-1478-7

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