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Outcome and management of isolated severe renal pelvis dilatation detected at postnatal screening

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Abstract

The aim of this study was to evaluate the incidence and outcome of isolated severe renal pelvis dilatation (RPD; APD > 15 ≤ 20 mm) in an unselected population of 2-month-old infants prospectively followed up for 12–14 months of life. Isolated severe renal pelvis dilatation was detected in 46 of the 11,801 (0.39%) infants screened. Nephro-urological investigations were initiated if RPD persisted, or if urinary tract infection (UTI) occurred during follow-up, and antibiotic therapy was administered only when UTI occurred. At follow-up, RPD persisted in 24 infants. Of these, 8 infants presented with vesico-ureteral reflux (VUR) of grade ≥ 3 and 16 with ureteropelvic junction obstruction (UPJO). Incidence of UTI was significantly higher (p < 0.001) in infants of the study group than in infants of the control group (13.9 vs 2.5%). Our data suggest that isolated severe RPD may be a self-limiting condition and that antibiotic prophylaxis (AP) for the prevention of UTI should not be performed. Considering RDP resolution and the incidence of UTI during follow-up, investigations for uropathy in infants with isolated, severe RPD are justified in persistent cases, or when UTI occurs during follow-up. Careful clinical monitoring for signs of UTI and treatment of each episode of UTI may be sufficient and safe.

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Authors and Affiliations

  1. Department of Paediatric and Surgery Sciences, University of Messina, 98124, Messina, Italy

    Carmelo Mamì, Antonella Palmara, Antonina Paolata, Teresa Marrone, Lucia Marseglia, Luca F. Bertè & Francesco Arena

  2. UO Neonatologia, Policlinico Universitario Messina, Via Consolare Valeria, 98100, Messina, Italy

    Carmelo Mamì

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  1. Carmelo Mamì
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  2. Antonella Palmara
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  3. Antonina Paolata
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  4. Teresa Marrone
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  5. Lucia Marseglia
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  6. Luca F. Bertè
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  7. Francesco Arena
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Correspondence to Carmelo Mamì.

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Mamì, C., Palmara, A., Paolata, A. et al. Outcome and management of isolated severe renal pelvis dilatation detected at postnatal screening. Pediatr Nephrol 25, 2093–2097 (2010). https://doi.org/10.1007/s00467-010-1573-3

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  • DOI: https://doi.org/10.1007/s00467-010-1573-3

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