A study on outcome of hydronephrosis among preschool children in tertiary care hospital
Journal Title: Medpulse International Journal of Anatomy - Year 2019, Vol 9, Issue 2
Abstract
Background: Hydronephrosis refers to the dilation of the renal collecting system caused by incomplete or complete obstruction. The ureteropelvic junction (UPJ) obstruction is the most common cause of congenital hydronephrosis, others are fibrous bands, kinks, crossing vessels, vesicoureteric reflux, multicystic kidney, ureterocoele, posterior urethral valve etc. If left untreated it may lead to chronic renal failure. Genetic and environmental factors may also influence hydronephrosis. Aim: The hydronephrosis is one of the most common renal abnormalities detected during routine pre and postnatal ultrasonography (USG). The Renal pelvic diameter (RPD) 4 mm at 18-23 weeks and 10mm after 28 weeks are considered as the upper limit of normal. Our study is to assess the outcome of hydronephrosis among preschool children. Materials and Methods: 21 cases (aged less than 5yrs) who were diagnosed as hydronephrosis by pre and postnatal USG attended the pediatric OPD. In a few cases, the function of the kidney was assessed by 99Tc- diethylene triamine penta-acetic acid scan (DTPA). Based on the old records, the outcomes of hydronephrosis were assessed. Results: The ureteropelvic junction (UPJ) obstruction was the main cause of hydronephrosis in 5 cases. Among these 2 cases were static (09.52%) and 3 cases were progressed (14.28%) and underwent pyeloplasty. Conclusion: 16 cases of hydronephrosis (76.19%) resolved within 1-3 years of life. Surgery is indicated only in persistent progressive dilatation of renal pelvis with cortical thinning, abnormal biochemical parameters and extrinsic causes. The cases identified as pre and postnatal hydronephrosis are to be advised for regular follow up and to see the progress which will help to decide for surgery in progressive cases to avoid renal failure.
Authors and Affiliations
Gnanavel A, K Maheswari, Sathish Narayan
Keywords
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