View in EDS

Clinical Outcomes and Follow-Up in Children With Prenatally Detected Unilateral Ureteropelvic Junction Obstruction

Saved in:
Bibliographic Details
Title: Clinical Outcomes and Follow-Up in Children With Prenatally Detected Unilateral Ureteropelvic Junction Obstruction
Authors: Malmström, Tim, Bekassy, Zivile, Salö, Martin, Tjernberg, Anna Röckert, Stenström, Pernilla
Contributors: Lund University, Faculty of Medicine, Department of Clinical Sciences, Lund, Section V, Paediatrics (Lund), Pediatric surgery, Lunds universitet, Medicinska fakulteten, Institutionen för kliniska vetenskaper, Lund, Sektion V, Pediatrik, Lund, Barnkirurgi, Originator, Lund University, Faculty of Medicine, Department of Clinical Sciences, Lund, Section V, Paediatrics (Lund), Pediatric Nephrology, Lunds universitet, Medicinska fakulteten, Institutionen för kliniska vetenskaper, Lund, Sektion V, Pediatrik, Lund, Pediatrisk nefrologi, Originator, Lund University, Profile areas and other strong research environments, Lund University Profile areas, LU Profile Area: Light and Materials, Lunds universitet, Profilområden och andra starka forskningsmiljöer, Lunds universitets profilområden, LU profilområde: Ljus och material, Originator
Source: Acta Paediatrica, International Journal of Paediatrics. 114(8):2066-2072
Subject Terms: Medical and Health Sciences, Clinical Medicine, Pediatrics, Medicin och hälsovetenskap, Klinisk medicin, Pediatrik
Description: Aim: To explore the possibility of reducing the diagnostic burden in children with prenatally detected unilateral ureteropelvic junction obstruction. Methods: Children with unilateral ureteropelvic junction obstruction (2012–2020) were identified from a prenatal hydronephrosis registry. The frequency of adverse events, predictors for event-free follow-up beyond 1 year of age, and examination burden in children with conservatively managed unilateral ureteropelvic junction obstruction were assessed. Adverse events included febrile urinary tract infections, > 10% decline in differential renal function, or both, leading to surgery. Follow-up ended at clinical conclusion or surgical decision. Results: Forty-seven children were included, with a follow-up of median 22.5 (2–115, min-max) months. Overall, 43% (20/47) had no adverse events. Adverse events occurred within 2 years in 85% (23/27). Predictors of event-free follow-up beyond 1 year were a postnatal anteroposterior diameter < 15 mm at 12 months (p < 0.001) ora stable anteroposterior diameter during the first year (p = 0.04). Patients without adverse events underwent a median of eight (3–26, min–max) diagnostic imaging examinations. Conclusions: In children with antenatally detected ureteropelvic junction obstruction, 43% had no adverse events, but a substantial examination burden. Predictors of a non-eventful trace, useful in guidelines, were a postnatal anteroposterior diameter < 15 mm or stable at 12 months.
Access URL: https://doi.org/10.1111/apa.70086
Database: SwePub
Description
Abstract:Aim: To explore the possibility of reducing the diagnostic burden in children with prenatally detected unilateral ureteropelvic junction obstruction. Methods: Children with unilateral ureteropelvic junction obstruction (2012–2020) were identified from a prenatal hydronephrosis registry. The frequency of adverse events, predictors for event-free follow-up beyond 1 year of age, and examination burden in children with conservatively managed unilateral ureteropelvic junction obstruction were assessed. Adverse events included febrile urinary tract infections, > 10% decline in differential renal function, or both, leading to surgery. Follow-up ended at clinical conclusion or surgical decision. Results: Forty-seven children were included, with a follow-up of median 22.5 (2–115, min-max) months. Overall, 43% (20/47) had no adverse events. Adverse events occurred within 2 years in 85% (23/27). Predictors of event-free follow-up beyond 1 year were a postnatal anteroposterior diameter < 15 mm at 12 months (p < 0.001) ora stable anteroposterior diameter during the first year (p = 0.04). Patients without adverse events underwent a median of eight (3–26, min–max) diagnostic imaging examinations. Conclusions: In children with antenatally detected ureteropelvic junction obstruction, 43% had no adverse events, but a substantial examination burden. Predictors of a non-eventful trace, useful in guidelines, were a postnatal anteroposterior diameter < 15 mm or stable at 12 months.
ISSN:08035253
16512227
DOI:10.1111/apa.70086