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• W2040251851 abstract "No AccessJournal of UrologyPediatric Urology1 Jul 1995Pyeloplasty Improves Renal Function and Somatic Growth in Children with Ureteropelvic Junction Obstruction Jorge Tapia and Ricardo Gonzalez Jorge TapiaJorge Tapia More articles by this author and Ricardo GonzalezRicardo Gonzalez More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(01)67280-XAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail We studied the systemic effects of pyeloplasty in 38 children with unilateral ureteropelvic junction obstruction. Mean patient age at surgery was 2.5 years and 22 patients were age 1 year or younger. Mean followup was 18 months. We recorded serum creatinine levels, glomerular filtration rate calculated by the Schwartz formula body growth, the degree of dilatation and the excretory curve of the diuresis renogram. Pyeloplasty was effective in decreasing the degree of ultrasonographic dilatation and the excretory curve of the renogram in 36 cases. Two patients required reoperation. Individual renal function improved significantly in children younger than 1 year with preoperative differential function less than 45 percent but not in older children. Serum creatinine level decreased significantly after pyeloplasty in all children. Likewise, glomerular filtration rate improved significantly in all children. Preoperatively, 72 percent of children younger than 1 year were below the 50th percentile in height. The distribution of heights became normal after surgery. Overall, percentile rank for height increased in a significant number of patients of all ages. We conclude that unilateral hydronephrosis systemically affects body growth and overall renal function, the salutary effect of pyeloplasty goes beyond the affected kidney and pyeloplasty may be of greater benefit when performed in infancy. These parameters must be considered in protocols designed to compare outcomes in children with hydronephrosis treated surgically with those who are simply observed. References 1 : Postoperative diuresis renography and ultrasound in patients undergoing pyeloplasty. Predictors of surgical outcome. Clin. Nucl. Med.1993; 18: 872. Google Scholar 2 : Nonoperative management of unilateral neonatal hydronephrosis. J. Urol.1992; 148: 525. Link, Google Scholar 3 : The postnatal management of hydronephrosis diagnosed by prenatal ultrasound. J. Urol.1990; 144: 584. Link, Google Scholar 4 : Posterior lumbotomy for pediatric pyeloplasty. J. Urol.1987; 137: 468. Abstract, Google Scholar 5 : Outcome of hydronephrosis diagnosed antenatally. J. Ped. Surg.1991; 26: 455. Google Scholar 6 : Ultrasound grading of hydronephrosis: introduction to the system used by the Society for Fetal Urology. Ped. Rad.1993; 23: 478. Crossref, Medline, Google Scholar 7 : The use of plasma creatinine concentration for estimating glomerular filtration rate in infants, children, and adolescents. Ped. Clin. N. Amer.1987; 34: 571. Google Scholar 8 : Physical growth: National Center for Health Statistics percentiles. Amer. J. Clin. Nutr.1979; 32: 607. Google Scholar 9 : Management of ureteropelvic junction obstruction in infants and neonates. Eur. Urol.1988; 15: 103. Google Scholar 10 : Pediatric pyeloplasty. J. Ped. Surg.1980; 15: 133. Google Scholar 11 : Management of ureteropelvic junction obstruction in the first year of life. J. Urol.1980; 123: 535. Abstract, Google Scholar 12 : Renal function in obstructive nephropathy: long-term effect of reconstructive surgery. Pediatrics1975; 56: 740. Google Scholar 13 : The case for immediate pyeloplasty in the neonate with ureteropelvic junction obstruction. J. Urol.1984; 132: 725. Link, Google Scholar 14 : Studies of renal function in children with chronic hydronephrosis. Ped. Clin. N. Amer.1971; 18: 445. Google Scholar 15 : Regulation of renal functional development. Urol. Clin. N. Amer.1980; 7: 243. Google Scholar 16 : Response of the developing kidney to nephron loss. In: Pediatric Kidney Disease. Edited by . Boston: Little, Brown and Co.1992: 443. chapt. 17. Google Scholar 17 : Plasma creatinine and urea concentration in children: normal values for age and sex. J. Ped.1976; 88: 828. Google Scholar 18 : Clinical and laboratory evaluation of renal function. In: Pediatric Kidney Disease. Edited by . Boston: Little, Brown and Co.1992: 461. chapt. 18. Google Scholar 19 : Renal response to ureteral obstruction in early development. Nephron1990; 56: 113. Google Scholar 20 : Monitoring renal function in children with urological abnormalities. J. Urol.1990; 144: 601. Abstract, Google Scholar Department of Pediatric Urology, Children's Hospital of Michigan, Wayne State University, Detroit, Michigan, and Division of Pediatric Urology, Variety Club Children's Hospital, University of Minnesota, Minneapolis, Minnesota.© 1995 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byAlmodhen F, Jednak R, Capolicchio J, Eassa W, Brzezinski A and El-Sherbiny M (2010) Is Routine Renography Required After Pyeloplasty?Journal of Urology, VOL. 184, NO. 3, (1128-1133), Online publication date: 1-Sep-2010.ESKILD-JENSEN A, GORDON I, PIEPSZ A and FRØKIÆR J (2018) CONGENITAL UNILATERAL HYDRONEPHROSIS: A REVIEW OF THE IMPACT OF DIURETIC RENOGRAPHY ON CLINICAL TREATMENTJournal of Urology, VOL. 173, NO. 5, (1471-1476), Online publication date: 1-May-2005.CHIOU Y, CHIU N, WANG S, CHENG H and TANG M (2018) Factors Associated With the Outcomes of Children With Unilateral Ureteropelvic Junction ObstructionJournal of Urology, VOL. 171, NO. 1, (397-402), Online publication date: 1-Jan-2004.POHL H, RUSHTON H, PARK J, BELMAN A and MAJD M (2018) EARLY DIURESIS RENOGRAM FINDINGS PREDICT SUCCESS FOLLOWING PYELOPLASTYJournal of Urology, VOL. 165, NO. 6 Part 2, (2311-2315), Online publication date: 1-Jun-2001.Palmer L, Maizels M, Cartwright P, Fernbach S and Conway J (2018) SURGERY VERSUS OBSERVATION FOR MANAGING OBSTRUCTIVE GRADE 3 TO 4 UNILATERAL HYDRONEPHROSIS: A REPORT FROM THE SOCIETY FOR FETAL UROLOGYJournal of Urology, VOL. 159, NO. 1, (222-228), Online publication date: 1-Jan-1998.Amling C, O'Hara S, Wiener J, Schaeffer C and King L (2018) Renal Ultrasound Changes After Pyeloplasty in Children With Ureteropelvic Junction Obstruction: Long-term Outcome in 47 Renal UnitsJournal of Urology, VOL. 156, NO. 6, (2020-2024), Online publication date: 1-Dec-1996. Volume 154Issue 1July 1995Page: 218-222 Advertisement Copyright & Permissions© 1995 by American Urological Association, Inc.MetricsAuthor Information Jorge Tapia More articles by this author Ricardo Gonzalez More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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