Results of Treatment of Neonatal Hydronephrosis
Authors:
J. Sedláček 1; R. Kočvara 1,4; Jakub Langer 2
; Z. Dítě 1,4; J. Dvořáček 1; H. Jiskrová 3
Authors place of work:
Urologická klinika VFN a UK 1. LF, Praha
přednosta prof. MUDr. J. Dvořáček, DrSc.
1; Klinika dětského a dorostového lékařství VFN a UK 1. LF, Praha
přednosta prof. MUDr. J. Zeman, DrSc.
2; Ústav nukleární medicíny VFN a UK 1. LF, Praha
přednosta prof. MUDr. M. Šámal, DrSc.
3; Institut postgraduálního vzdělávání ve zdravotnictví, Praha
ředitel MUDr. Z. Hadra
4
Published in the journal:
Čes-slov Pediat 2008; 63 (12): 653-659.
Category:
Original Papers
Summary
Study objective:
Evaluation of 141 newborns and sucklings with unilateral asymptomatic hydronephrosis (HN) aimed at natural development of kidney function and development of kidney function in relation to surgical treatment.
Methods:
The cohort was divided in two groups. The first group with HN grade I–II included 82 children and 2nd group with HN grade III–IV included 59 children. Individuals in both groups were followed conservatively. In the course of observation, 29 children were operated on, all of them from the 2nd group. The surgery was indicated by growing degree of HN in 14 patients (group 2/A), decrease of the separated kidney function in 12 cases (group 2/B) and low separated kidney function during the first examination in three cases (group 2/C). The remaining 30 children of the 2nd group were not treated by surgery (group 2/D). The mean period of observation was 28 months (3 to 165 months).
Results:
In the group 1 and 2/D there was a gradual decrease of HN and the kidney function proved to be good during the period of observation. In the group of children operated on for growing dilatation (2/A), the separated function remained stationary (46% versus 49%); in the group of children with decreased separated kidney function (2/B), it proved to adjust after the operation (46% versus 36% versus 43%), whereas in the kidneys with primarily low function (2/C) there was only an improvement (19% vs. 34%).
Conclusion:
Congenital hydronephrosis of lower grade (I–II) and more than a half of hydronephrosis cases of higher grade (III–IV) is associated with a favorable development during the conservative follow-up. Twenty one percent of children underwent surgery for increased dilatation of the calix-pelvic system, decrease of the separated function or primary hypofunction of the affected kidney. The post-operation function was dependent on primary function of the affected kidney. The decrease of the separated function was reversible in all individuals.
Key words:
neonatal hydronephrosis, pyeloureteral obstruction, pyeloplasty
Zdroje
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Štítky
Neonatology Paediatrics General practitioner for children and adolescentsČlánok vyšiel v časopise
Czech-Slovak Pediatrics
2008 Číslo 12
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