A Midhat Elmaci1, M İrfan Dönmez2. 1. Pediatric Nephrology, Dr. Ali Kemal Belviranli Women's Maternity and Children's Hospital, Konya, Turkey. 2. Pediatric Urology, Konya Training and Research Hospital, Hacı Şaban Mah., Yeni Meram Cad. No: 97, 42090, Konya, Turkey. m_irfan83@yahoo.com.
Abstract
Data regarding spontaneous resolution of mild hydronephrosis consist of different etiologies, and hence, it is heterogeneous. The aim of this study is to evaluate spontaneous resolution rates and the time to complete resolution of antenatally detected isolated hydronephrosis in patients with renal pelvis antero-posterior diameter (RPAPD) ≤ 20 mm. Retrospective chart review of patients who were admitted to our pediatric nephrology clinic for the evaluation of antenatal hydronephrosis between 2011 and 2017 was conducted. Patients that had hydronephrosis with RPAPD ≤ 20 mm, < SFU (Society for Fetal Urology) grade IV on initial postnatal evaluation, and ≥ 3 months of follow-up with at least two renal ultrasounds (US) were included. Complete resolution of hydronephrosis was regarded as SFU grade 0 with a RPAPD of < 7 mm. Patients with ureteric and lower urinary tract abnormalities were excluded. There were a total of 276 patients who met the inclusion criteria. Median follow-up was 16 months (range 3-96 months). Hydronephrosis completely resolved in 198 patients (71.7%). Surgery was not required in any of the patients; however, nine patients (3.3%) showed progression to higher grades of hydronephrosis or increase in AP diameter. Median time to complete resolution of hydronephrosis was 6 months (range 2-35 months) in our study. Those with AP diameter < 10 mm became normal in median of 5 months, while it took median 11 months for patients with AP diameter 10-20 mm to become normalized (p < 0.001). Conclusion: Isolated antenatal hydronephrosis with RPAPD ≤ 20 mm would spontaneously resolve in 71.7% of the cases. Resolution may be expected to happen in 3 years, while the majority will take place in the first year of life. What is Known: • Antenatal hydronephrosis comprises an important amount of clinical visits. • Spontaneous resolution rates differ for various etiologies. What is New: • Isolated antenatal hydronephrosis with RPAPD ≤ 20 mm completely resolves within 3 years in approximately 72% of the cases. • Resolution can be observed within the first year of life in most of the cases.
Data regarding spontaneous resolution of mild hydronephrosis consist of different etiologies, and hence, it is heterogeneous. The aim of this study is to evaluate spontaneous resolution rates and the time to complete resolution of antenatally detected isolated hydronephrosis in patients with renal pelvis antero-posterior diameter (RPAPD) ≤ 20 mm. Retrospective chart review of patients who were admitted to our pediatric nephrology clinic for the evaluation of antenatal hydronephrosis between 2011 and 2017 was conducted. Patients that had hydronephrosis with RPAPD ≤ 20 mm, < SFU (Society for Fetal Urology) grade IV on initial postnatal evaluation, and ≥ 3 months of follow-up with at least two renal ultrasounds (US) were included. Complete resolution of hydronephrosis was regarded as SFU grade 0 with a RPAPD of < 7 mm. Patients with ureteric and lower urinary tract abnormalities were excluded. There were a total of 276 patients who met the inclusion criteria. Median follow-up was 16 months (range 3-96 months). Hydronephrosis completely resolved in 198 patients (71.7%). Surgery was not required in any of the patients; however, nine patients (3.3%) showed progression to higher grades of hydronephrosis or increase in AP diameter. Median time to complete resolution of hydronephrosis was 6 months (range 2-35 months) in our study. Those with AP diameter < 10 mm became normal in median of 5 months, while it took median 11 months for patients with AP diameter 10-20 mm to become normalized (p < 0.001). Conclusion: Isolated antenatal hydronephrosis with RPAPD ≤ 20 mm would spontaneously resolve in 71.7% of the cases. Resolution may be expected to happen in 3 years, while the majority will take place in the first year of life. What is Known: • Antenatal hydronephrosis comprises an important amount of clinical visits. • Spontaneous resolution rates differ for various etiologies. What is New: • Isolated antenatal hydronephrosis with RPAPD ≤ 20 mm completely resolves within 3 years in approximately 72% of the cases. • Resolution can be observed within the first year of life in most of the cases.
Authors: Hiep T Nguyen; C D Anthony Herndon; Christopher Cooper; John Gatti; Andrew Kirsch; Paul Kokorowski; Richard Lee; Marcos Perez-Brayfield; Peter Metcalfe; Elizabeth Yerkes; Marc Cendron; Jeffrey B Campbell Journal: J Pediatr Urol Date: 2010-04-15 Impact factor: 1.830
Authors: Cristiane S Dias; José Maria Penido Silva; Alamanda K Pereira; Viviane S Marino; Leandro A Silva; Alessandra M Coelho; Fernanda P Costa; Isabel G Quirino; Ana Cristina Simões E Silva; Eduardo A Oliveira Journal: J Urol Date: 2013-02-14 Impact factor: 7.450
Authors: Hiep T Nguyen; Carol B Benson; Bryann Bromley; Jeffrey B Campbell; Jeanne Chow; Beverly Coleman; Christopher Cooper; Jude Crino; Kassa Darge; C D Anthony Herndon; Anthony O Odibo; Michael J G Somers; Deborah R Stein Journal: J Pediatr Urol Date: 2014-11-15 Impact factor: 1.830
Authors: Carlo C Passerotti; Leslie A Kalish; Jeannie Chow; Ana Maria A M S Passerotti; Pedro Recabal; Marc Cendron; Richard S Lee; Arielle Bressler Lopez; Alan B Retik; Hiep T Nguyen Journal: J Pediatr Urol Date: 2010-10-14 Impact factor: 1.830
Authors: Graziela M Coelho; Maria Candida F Bouzada; Alamanda K Pereira; Bruno F Figueiredo; Maria Rafaela S Leite; Danielly S Oliveira; Eduardo A Oliveira Journal: Pediatr Nephrol Date: 2007-07-26 Impact factor: 3.714