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- W2055148727 abstract "No AccessJournal of UrologyPediatric Urology1 Jul 2012Factors Predicting Improvement of Renal Function After Pyeloplasty in Pediatric Patients: A Prospective Study Saurabh S. Chipde, Hira Lal, S. Gambhir, Jatinder Kumar, Aneesh Srivastava, Rakesh Kapoor, and M.S. Ansari Saurabh S. ChipdeSaurabh S. Chipde Department of Urology and Kidney Transplantation, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India More articles by this author , Hira LalHira Lal Department of Radiology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India More articles by this author , S. GambhirS. Gambhir Department of Nuclear Medicine, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India More articles by this author , Jatinder KumarJatinder Kumar Department of Urology and Kidney Transplantation, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India More articles by this author , Aneesh SrivastavaAneesh Srivastava Department of Urology and Kidney Transplantation, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India More articles by this author , Rakesh KapoorRakesh Kapoor Department of Urology and Kidney Transplantation, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India More articles by this author , and M.S. AnsariM.S. Ansari Department of Urology and Kidney Transplantation, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.03.023AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We assessed the specific preoperative sonographic and urinary factors that may be important in predicting renal function outcomes after pyeloplasty. Materials and Methods: We prospectively studied 52 consecutive patients with ureteropelvic junction obstruction who underwent pyeloplasty at our tertiary care center between September 2009 and January 2011. Mean ± 2 SD patient age was 4.26 years (range 3 months to 18 years), and minimum followup was 6 months. Preoperative ultrasound findings recorded were pelvic anteroposterior diameter, pelvic cortical thickness, pelvic volume and pelvic cortical ratio. Spot urine protein-to-creatinine ratio from the renal pelvis and bladder was measured intraoperatively. Based on changes in differential renal function on diuretic renogram, patients were divided into 3 groups. Group 1 had stable differential renal function with less than 5% change, group 2 had improved differential renal function greater than 5% and group 3 had deterioration of differential renal function greater than 5%. Data were analyzed using SPSS®, version 17 with cross-tabulation, nonparametric tests and logistic regression. Results: On ultrasound only anteroposterior diameter (p = 0.018) and pelvic cortical ratio (p = 0.038) were significantly different among the 3 groups. Difference in bladder sample protein-to-creatinine ratio was not significant (p = 0.69), while pelvic urine protein-to-creatinine ratio was significant (p = 0.001). Anteroposterior diameter, pelvic protein-to-creatinine ratio and pelvic cortical ratio were less than 50 mm, 0.5 and 15, respectively, in all patients with improved renal function. Conclusions: Sonographic and urinary biochemical parameters may predict improvement in renal function after pyeloplasty. Pelvic anteroposterior diameter, pelvic cortical ratio and pelvic urine protein-to-creatinine ratio are the most useful parameters. References 1 : Calyx to parenchyma ratio in pelvi-ureteric junction obstruction. BJU Int2002; 89: 73. Google Scholar 2 : Conservative treatment of ureteropelvic junction obstruction in children with antenatal diagnosis of hydronephrosis: lessons learned after 16 years of follow-up. Eur Urol2006; 49: 734. Google Scholar 3 : The “well tempered” diuretic renogram: a standard method to examine the asymptomatic neonate with hydronephrosis or hydroureteronephrosis: A report from combined meetings of the Society for Fetal Urology and members of the Pediatric Nuclear Medicine Council—The Society of Nuclear Medicine. J Nucl Med1992; 33: 2047. Google Scholar 4 : Antenatal hydronephrosis as a predictor of postnatal outcome: a meta-analysis. Pediatrics2006; 118: 586. Google Scholar 5 : Surgery versus observation for managing obstructive grade 3 to 4 unilateral hydronephrosis: a report from the Society for Fetal Urology. J Urol1998; 159: 222. Link, Google Scholar 6 : Pelvis/cortex ratio: a sonographic marker of pelviureteric junction obstruction in children. Indian J Urol2010; 26: 494. Google Scholar 7 : Pelvis/cortex ratio in pelviureteric junction obstruction. Indian J Urol2010; 26: 472. Google Scholar 8 : functional immature model of chronic partial ureteral obstruction. Kidney Int2004; 65: 1155. Google Scholar 9 : Long-term results of pyeloplasty in poorly functioning kidneys in the pediatric age group. J Pediatr Urol2012; 8: 25. Google Scholar 10 : Prediction of outcome of antenatally diagnosed hydronephrosis: a multivariable analysis. J Pediatr Urol2012; 8: 135. Google Scholar 11 : Correlation of hydronephrosis index to Society for Fetal Urology hydronephrosis scale. Adv Urol2009; 2009: 960490. Google Scholar 12 : Pelvis/cortex ratio: an early marker of success following pyeloplasty in children. J Pediatr Urol2010; 6: 473. Google Scholar 13 : Use of a first-line urine protein-to-creatinine ratio strip test on random urines to rule out proteinuria in patients with chronic kidney disease. Nephrol Dial Transplant2009; 24: 1189. Google Scholar 14 : A comparison of spot urine protein-creatinine ratio with 24-hour urine protein excretion in women with preeclampsia. Iran J Kidney Dis2008; 2: 127. Google Scholar 15 : A prospective comparison of total protein/creatinine ratio versus 24-hour urine protein in women with suspected preeclampsia. Am J Obstet Gynecol2003; 189: 848. Google Scholar 16 : Use of protein: creatinine ratio measurements on random urine samples for prediction of significant proteinuria: a systematic review. Clin Chem2005; 51: 1577. Google Scholar 17 : Long-term functional and morphological outcome after pyeloplasty for huge renal pelvis. BJU Int2011; 107: 829. Google Scholar 18 : Congenital hydronephrosis detected by prenatal ultrasonography: the effect of pyeloplasty on renal function. Nihon Hinyokika Gakkai Zasshi2000; 91: 473. Google Scholar © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byHarraz A, Helmy T, Taha D, Shalaby I, Sarhan O, Dawaba M and Hafez A (2013) Changes in Differential Renal Function after Pyeloplasty in ChildrenJournal of Urology, VOL. 190, NO. 4S, (1468-1473), Online publication date: 1-Oct-2013.Dias C, Silva J, Pereira A, Marino V, Silva L, Coelho A, Costa F, Quirino I, Simões e Silva A and Oliveira E (2018) 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. Volume 188Issue 1July 2012Page: 262-265 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.Keywordsureteral obstructiontreatment outcomekidney pelvisurologic surgical proceduresMetricsAuthor Information Saurabh S. Chipde Department of Urology and Kidney Transplantation, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India More articles by this author Hira Lal Department of Radiology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India More articles by this author S. Gambhir Department of Nuclear Medicine, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India More articles by this author Jatinder Kumar Department of Urology and Kidney Transplantation, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India More articles by this author Aneesh Srivastava Department of Urology and Kidney Transplantation, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India More articles by this author Rakesh Kapoor Department of Urology and Kidney Transplantation, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India More articles by this author M.S. Ansari Department of Urology and Kidney Transplantation, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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