Resolution rate of isolated low-grade hydronephrosis diagnosed within the first year of life.

Journal Article (Journal Article)

OBJECTIVE: Diagnosis of low-grade hydronephrosis often occurs prenatally, during evaluation after urinary tract infection (UTI), or imaging for non-urologic reasons within the first year of life. Its significance in terms of resolution, need for antibiotic prophylaxis, or progression to surgery remains uncertain. We hypothesized that isolated low-grade hydronephrosis in this population frequently resolves, UTIs are infrequent, and progression to surgical intervention is minimal. PATIENTS AND METHODS: Children < 12 months old diagnosed hydronephrosis (Society for Fetal Urology [SFU] grade 1 or 2) between January 2004 and December 2009 were identified by ICD9 code. Patients with other urological abnormalities were excluded. Stability of hydronephrosis, UTI (≥ 100,000 CFU/mL bacterial growth) or need for surgical intervention was noted. RESULTS: Of 1496 infants with hydronephrosis, 416 (623 renal units) met inclusion criteria. Of 398 renal units with grade 1 hydronephrosis, 385 (96.7%) resolved or remained stable. Only 13 (3.3%) worsened, of which one underwent ureteroneocystostomy. Of 225 renal units with grade 2 hydronephrosis, 222 (98.7%) resolved, improved or remained stable, three (1.3%) worsened, of which one required pyeloplasty. Only 0.7% of patients in the ambulatory setting had a febrile UTI. CONCLUSIONS: Low-grade hydronephrosis diagnosed within the first year of life remains stable or improves in 97.4% of renal units. Given the low rate of recurrent UTI in the ambulatory setting, antibiotic prophylaxis has a limited role in management.

Full Text

Duke Authors

Cited Authors

  • Madden-Fuentes, RJ; McNamara, ER; Nseyo, U; Wiener, JS; Routh, JC; Ross, SS

Published Date

  • August 2014

Published In

Volume / Issue

  • 10 / 4

Start / End Page

  • 639 - 644

PubMed ID

  • 25185821

Pubmed Central ID

  • PMC4387886

Electronic International Standard Serial Number (EISSN)

  • 1873-4898

Digital Object Identifier (DOI)

  • 10.1016/j.jpurol.2014.07.004


  • eng

Conference Location

  • England