An alternative grading system to refine the criteria for severity of hydronephrosis and optimal treatment guidelines in neonates with primary UPJ-type hydronephrosis

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dc.contributor.authorÖnen, Abdurrahman
dc.contributor.orcid0000-0003-1671-4094
dc.date.accessioned2024-04-24T17:56:09Z
dc.date.available2024-04-24T17:56:09Z
dc.date.issued2007
dc.departmentDicle Üniversitesi, Tıp Fakültesi, Cerrahi Tıp Bilimleri Bölümü, Çocuk Cerrahisi Ana Bilim Dalıen_US
dc.description.abstractObjective: We present our alternative hydronephrosis grading system (AGS) in an attempt to establish optimal treatment guidelines, and clarify and refine the criteria for severity of hydronephrosis in neonates. Patients and methods: A total of 162 newborns (228 affected kidneys) with antenatally diagnosed primary ureteropelvic junction-type hydronephrosis were prospectively followed and treated by the same surgeon for a mean of 46 (6-65) months. Ultrasonography and diuretic renogram were used for diagnosis and follow up. Society for Fetal Urology (SFU) grading system, anteroposterior diameter of renal pelvis (APDRP) and our AGS were used to determine the degree of hydronephrosis. AGS: 0, no hydronephrosis; 1, dilatation of renal pelvis alone; 2, plus caliceal dilatation; 3, plus <1/2 (mild-to-moderate) renal parenchymal loss; 4, plus >1/2 (severe) renal parenchymal loss (cyst-like kidney with no visually significant renal parenchyma). Results: On the first postnatal ultrasound, the severity of hydronephrosis was SFU ? 2 in 152 kidneys (surgery, 0%), SFU-3 in 41 kidneys (surgery, 19.5%) and SFU-4 in 35 kidneys (surgery, 68.6%). The follow up, treatment and outcome of SFU-1 and SFU-2 patients were similar; all resolved spontaneously without renal deterioration (renal function >40%). Renal function ranged between 7% and 39% in SFU-4 patients. Intrarenal pelvis was found in one patient with an APDRP of <15 mm, seven patients of 16-30 mm, and five patients of >30 mm. Overall, 201 hydronephrotic kidneys (88.2%) resolved spontaneously while 27 (11.8%) required pyeloplasty. Conclusion: Neither an SFU grading system nor measurement of APDRP is the gold standard in determining the severity of hydronephrosis. Both methods may fail, particularly in children with intrarenal pelvis configuration or SFU-4 hydronephrosis. Our AGS promises easier follow up and more timely treatment.en_US
dc.identifier.citationÖnen, A. (2007). An alternative grading system to refine the criteria for severity of hydronephrosis and optimal treatment guidelines in neonates with primary UPJ-type hydronephrosis. Journal of Pediatric Urology, 3(3), 200-205.
dc.identifier.doi10.1016/j.jpurol.2006.08.002
dc.identifier.endpage205en_US
dc.identifier.issn1477-5131
dc.identifier.issue3en_US
dc.identifier.scopus2-s2.0-34247555466
dc.identifier.scopusqualityQ2
dc.identifier.startpage200en_US
dc.identifier.urihttps://doi.org/10.1016/j.jpurol.2006.08.002
dc.identifier.urihttps://hdl.handle.net/11468/23332
dc.identifier.urihttps://www.sciencedirect.com/science/article/pii/S1477513106001598?via%3Dihub
dc.identifier.volume3en_US
dc.indekslendigikaynakScopus
dc.institutionauthorÖnen, Abdurrahman
dc.language.isoenen_US
dc.relation.ispartofJournal of Pediatric Urology
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectChildrenen_US
dc.subjectFollow Upen_US
dc.subjectGradingen_US
dc.subjectHydronephrosisen_US
dc.subjectTreatmenten_US
dc.titleAn alternative grading system to refine the criteria for severity of hydronephrosis and optimal treatment guidelines in neonates with primary UPJ-type hydronephrosisen_US
dc.titleAn alternative grading system to refine the criteria for severity of hydronephrosis and optimal treatment guidelines in neonates with primary UPJ-type hydronephrosis
dc.typeArticleen_US

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