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Value of renal pelvic diameter and urinary tract dilation classification in the prediction of urinary tract anomaly. | LitMetric

AI Article Synopsis

  • The study aimed to determine critical cut-offs for postnatal renal pelvic diameter measurements to guide the diagnosis and treatment of urinary tract dilation (UTD) in infants.
  • A total of 260 infants with UTD were assessed using serial ultrasounds, revealing that those with temporary dilation had lower renal pelvic diameters compared to those with urinary tract anomalies.
  • The findings support that the UTD classification system effectively predicts whether patients will require surgery based on the measurements taken during postnatal evaluations.

Article Abstract

Background: The aim of this study was to identify the cut-offs of postnatal anteroposterior renal pelvic diameter (APRPD), according to the urinary tract dilation (UTD) classification system, to identify the predictors of final diagnosis of UTD and the need for surgery.

Methods: A total of 260 infants (336 renal units) with prenatally detected UTD were prospectively evaluated on serial ultrasonography by the same radiologist. Additional voiding cystourethrography and scintigraphy was done according to the clinical algorithm.

Results: Prenatal and postnatal APRPD in patients with transient dilation were significantly lower than in those with urinary tract anomalies (UTA). On follow up, the slope of decrease in APRPD was significantly higher in transient dilation compared with UTA. APRPD 10 mm at first-month ultrasonography, predicted UTA with a sensitivity of 83.1%, and specificity of 71.1%. On multivariate analysis the likelihood of surgical intervention and final diagnosis were predicted independently by the UTD system risk group.

Conclusions: Careful ultrasonography evaluation can avoid unnecessary testing in patients with transient or clinically insignificant dilation. The UTD classification system is valid for evaluation of postnatal hydronephrosis and is reliable in predicting the need for surgical intervention.

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Source
http://dx.doi.org/10.1111/ped.13788DOI Listing

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