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

Publication ,  Journal Article
Madden-Fuentes, RJ; McNamara, ER; Nseyo, U; Wiener, JS; Routh, JC; Ross, SS
Published in: J Pediatr Urol
August 2014

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.

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Published In

J Pediatr Urol

DOI

EISSN

1873-4898

Publication Date

August 2014

Volume

10

Issue

4

Start / End Page

639 / 644

Location

England

Related Subject Headings

  • Urology & Nephrology
  • Urinary Tract Infections
  • Severity of Illness Index
  • Outcome Assessment, Health Care
  • Male
  • Infant, Newborn
  • Infant
  • Hydronephrosis
  • Humans
  • Female
 

Citation

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ICMJE
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Madden-Fuentes, R. J., McNamara, E. R., Nseyo, U., Wiener, J. S., Routh, J. C., & Ross, S. S. (2014). Resolution rate of isolated low-grade hydronephrosis diagnosed within the first year of life. J Pediatr Urol, 10(4), 639–644. https://doi.org/10.1016/j.jpurol.2014.07.004
Madden-Fuentes, Ramiro J., Erin R. McNamara, Unwanaobong Nseyo, John S. Wiener, Jonathan C. Routh, and Sherry S. Ross. “Resolution rate of isolated low-grade hydronephrosis diagnosed within the first year of life.J Pediatr Urol 10, no. 4 (August 2014): 639–44. https://doi.org/10.1016/j.jpurol.2014.07.004.
Madden-Fuentes RJ, McNamara ER, Nseyo U, Wiener JS, Routh JC, Ross SS. Resolution rate of isolated low-grade hydronephrosis diagnosed within the first year of life. J Pediatr Urol. 2014 Aug;10(4):639–44.
Madden-Fuentes, Ramiro J., et al. “Resolution rate of isolated low-grade hydronephrosis diagnosed within the first year of life.J Pediatr Urol, vol. 10, no. 4, Aug. 2014, pp. 639–44. Pubmed, doi:10.1016/j.jpurol.2014.07.004.
Madden-Fuentes RJ, McNamara ER, Nseyo U, Wiener JS, Routh JC, Ross SS. Resolution rate of isolated low-grade hydronephrosis diagnosed within the first year of life. J Pediatr Urol. 2014 Aug;10(4):639–644.
Journal cover image

Published In

J Pediatr Urol

DOI

EISSN

1873-4898

Publication Date

August 2014

Volume

10

Issue

4

Start / End Page

639 / 644

Location

England

Related Subject Headings

  • Urology & Nephrology
  • Urinary Tract Infections
  • Severity of Illness Index
  • Outcome Assessment, Health Care
  • Male
  • Infant, Newborn
  • Infant
  • Hydronephrosis
  • Humans
  • Female