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• W2054769953 abstract "No AccessJournal of UrologyPediatric Urology1 Nov 2009Predictive Factors for Vesicoureteral Reflux and Prenatally Diagnosed Renal Pelvic Dilatation Cristiane S. Dias, Maria Candida F. Bouzada, Alamanda K. Pereira, Paola S. Barros, Ana Cristina L. Chaves, Aline P. Amaro, and Eduardo A. Oliveira Cristiane S. DiasCristiane S. Dias More articles by this author , Maria Candida F. BouzadaMaria Candida F. Bouzada More articles by this author , Alamanda K. PereiraAlamanda K. Pereira More articles by this author , Paola S. BarrosPaola S. Barros Supported by Brazilian National Research Council. More articles by this author , Ana Cristina L. ChavesAna Cristina L. Chaves More articles by this author , Aline P. AmaroAline P. Amaro Supported by Brazilian National Research Council. More articles by this author , and Eduardo A. OliveiraEduardo A. Oliveira Supported by Brazilian National Research Council. More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2009.07.058AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We sought to identify predictive factors for primary vesicoureteral reflux among infants with prenatally detected renal pelvic dilatation. Materials and Methods: A total of 250 neonates were diagnosed with isolated renal pelvic dilatation between 1999 and 2008, and followed prospectively. The main event of interest was presence of moderate to severe reflux (grade III to V). Diagnostic odds ratio, sensitivity, specificity, and diagnostic accuracy (assessed by AUC) of fetal and postnatal renal pelvic dilatation were determined. Severity of dilatation was classified by Society for Fetal Urology grade. Binary logistic regression was performed to identify variables significantly associated with vesicoureteral reflux. Results: A total of 23 patients (9.2%) had primary vesicoureteral reflux, of whom 16 had grade III to V disease. Diagnostic accuracy was 0.70 (95% CI 0.63 to 0.75) for fetal and 0.65 (95% CI 0.59 to 0.71) for postnatal renal pelvic dilatation. Combined results of fetal and postnatal renal pelvic dilatation were also assessed. When both tests less than 10 mm were considered negative indicators of moderate to severe vesicoureteral reflux sensitivity increased to 97% and diagnostic odds ratio to 19.1. After adjustment by logistic regression only Society for Fetal Urology grade greater than I and ureteral dilatation were variables independently associated with grade III to V reflux. Conclusions: Fetal and postnatal renal pelvic dilatation was a poor predictor of vesicoureteral reflux. Nevertheless, diagnostic accuracy regarding clinically significant vesicoureteral reflux improved when fetal and postnatal renal pelvic dilatation less than 10 mm was considered a negative indicator of reflux. References 1 : Dilemmas in the radiological investigation of the renal tract in children. Curr Paediatr2003; 13: 448. Google Scholar 2 : Mild fetal renal pelvis dilatation: much ado about nothing?. Clin J Am Soc Nephrol2009; 4: 168. Google Scholar 3 : Antenatal hydronephrosis: Fetal and neonatal management. Pediatr Clin North Am1997; 44: 1299. Google Scholar 4 : Vesicoureteric reflux in the newborn: relationship to fetal renal pelvic diameter. Pediatr Nephrol1997; 11: 610. Google Scholar 5 : Vesicoureteral reflux in infants with isolated antenatal hydronephrosis. Pediatr Nephrol2003; 18: 1224. Google Scholar 6 : Primary vesicoureteric reflux—how useful is postnatal ultrasound?. Arch Dis Child1996; 75: 444. 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Google Scholar 21 : Prenatal hydronephrosis: early evaluation. Curr Opin Urol2008; 18: 401. Google Scholar 22 : Direct comparison of radiology and nuclear medicine cystograms in young infants with vesico-ureteric reflux. BJU Int2001; 87: 93. Google Scholar 23 : Bias in research studies. Radiology2006; 238: 780. Google Scholar 24 : Vesicoureteral reflux and urinary tract infection in children with a history of prenatal hydronephrosis—should voiding cystourethrography be performed in cases of postnatally persistent grade II hydronephrosis?. J Urol2009; 181: 801. Link, Google Scholar Pediatric Nephrourology Unit and Fetal Medicine Division (AKP), Department of Pediatrics, Hospital das Clinicas, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil© 2009 by American Urological AssociationFiguresReferencesRelatedDetailsCited ByMelo F, Mak R, Simões e Silva A, Vasconcelos M, Dias C, Rosa L, Shiomatsu G, Storch C, Oliveira M and Oliveira E (2021) Evaluation of Urinary Tract Dilation Classification System for Prediction of Long-Term Outcomes in Isolated Antenatal Hydronephrosis: A Cohort StudyJournal of Urology, VOL. 206, NO. 4, (1022-1030), Online publication date: 1-Oct-2021.Dias C, Silva J, Pereira A, Marino V, Silva L, Coelho A, Costa F, Quirino I, Simões e Silva A and Oliveira E (2013) Diagnostic Accuracy of Renal Pelvic Dilatation for Detecting Surgically Managed Ureteropelvic Junction ObstructionJournal of Urology, VOL. 190, NO. 2, (661-666), Online publication date: 1-Aug-2013.Quirino I, Silva J, Diniz J, Lima E, Rocha A, Simões e Silva A and Oliveira E (2010) Combined Use of Late Phase Dimercapto-Succinic Acid Renal Scintigraphy and Ultrasound as First Line Screening After Urinary Tract Infection in ChildrenJournal of Urology, VOL. 185, NO. 1, (258-263), Online publication date: 1-Jan-2011. Volume 182Issue 5November 2009Page: 2440-2445 Advertisement Copyright & Permissions© 2009 by American Urological AssociationKeywordsprenatal diagnosisvesico-ureteral refluxurinary tract infectionsfetal diseaseshydronephrosisMetricsAuthor Information Cristiane S. Dias More articles by this author Maria Candida F. Bouzada More articles by this author Alamanda K. Pereira More articles by this author Paola S. Barros Supported by Brazilian National Research Council. More articles by this author Ana Cristina L. Chaves More articles by this author Aline P. Amaro Supported by Brazilian National Research Council. More articles by this author Eduardo A. Oliveira Supported by Brazilian National Research Council. More articles by this author Expand All Advertisement PDF DownloadLoading ..." @default.
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