Long-term treatment results of hydronephrosis in children operated in their first year of life. A systematic review
- Authors: Bebenina A.A.1, Mokrushina O.G.1,2, Levitskaya M.V.2, Shumikhin V.S.1,2, Erokhina N.O.2, Agavelyan A.E.1
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Affiliations:
- Pirogov Russian National Research Medical University
- Filatov Children’s Hospital
- Issue: Vol 13, No 2 (2023)
- Pages: 189-200
- Section: Systematic reviews
- URL: https://journal-vniispk.ru/2219-4061/article/view/132773
- DOI: https://doi.org/10.17816/psaic1301
- ID: 132773
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Abstract
BACKGROUND: Congenital stenosis of the ureterоpelvic junction is the most common cause of hydronephrosis in children.
AIM: This systematic review aimed to search and analyze modern literature from 1998 to 2021 on the treatment and postoperative follow-up of children with severe hydronephrosis in the first year of life and study the long-term results.
MATERIALS AND METHODS: Literary sources were searched in PubMed, Web of Science, Scopus, Google Scholar, and eLibrary databases. The following keywords were used to search for English sources: congenital hydronephrosis, severe hydronephrosis, operative treatment, uretero-pelvic junction obstruction infant, children, neonatal, and infancy. Five full-text articles that meet the criteria were included for analysis.
RESULTS: A total of 355 patients were included in the publications. Antenatal screening was described only in two studies. The average age of children at the time of surgery was five months (one to six months). All the authors noted that due to pyeloplasty in the first year of life, the renal parenchyma exhibited a significant increase in thickness; the indicators in dynamics increased by an average of 1.5 times during the year. The size of the renal pelvis decreased by 50%–67%. The data of radioisotope scintigraphy were variable; however, in the long-term period, improvement in renal function was noted in all publications.
CONCLUSIONS: This systematic review shows the long-term results of early pyeloplasty in congenital hydronephrosis in young children. A significant decrease in the pelvis and an increase in the thickness of the parenchyma were observed, both of which are an advantage for the restoration of renal function. However, no single algorithm can predict the recovery of renal parenchyma. An accurate assessment of renal parenchymal function should be confirmed by a prospective, randomized, long-term, follow-up study with a large number of cases.
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##article.viewOnOriginalSite##About the authors
Anastasia A. Bebenina
Pirogov Russian National Research Medical University
Email: anastasia.bebenina@yandex.ru
ORCID iD: 0000-0002-8390-822X
SPIN-code: 5298-7083
postgraduate student
Russian Federation, MoscowOlga G. Mokrushina
Pirogov Russian National Research Medical University; Filatov Children’s Hospital
Email: mokrushina@yandex.ru
ORCID iD: 0000-0003-4444-6103
SPIN-code: 5998-7470
Dr. Sci. (Med.), MD, Professor of the Department of Pediatric Surgery
Russian Federation, Moscow; MoscowMarina V. Levitskaya
Filatov Children’s Hospital
Email: urolog@neosurg.ru
ORCID iD: 0000-0002-9838-9493
SPIN-code: 2609-2557
Cand. Sci. (Med.)
Russian Federation, MoscowVasily S. Shumikhin
Pirogov Russian National Research Medical University; Filatov Children’s Hospital
Email: vashou@gmail.com
ORCID iD: 0000-0001-9477-8785
SPIN-code: 6405-8928
Cand. Sci. (Med.)
Russian Federation, Moscow; MoscowNadezhda O. Erokhina
Filatov Children’s Hospital
Email: nadegdaerokhina@yandex.ru
ORCID iD: 0000-0003-0519-7220
SPIN-code: 5169-3443
Russian Federation, Moscow
Anzhelika E. Agavelyan
Pirogov Russian National Research Medical University
Author for correspondence.
Email: lika.lk@mail.ru
ORCID iD: 0009-0005-5361-8589
student
Russian Federation, MoscowReferences
- Schlomer BJ, Cohen RA, Baskin LS. Renal imaging: Congenital anomalies of the kidney and urinary tract. In: Pediatric and adolescent urologic imaging. New York: Springer; 2014. P. 155–198. doi: 10.1007/978-1-4614-8654-1_9
- Bendre PS, Karkera PJ, Nanjappa M. Functional outcome after neonatal pyeloplasty in antenatally diagnosed uretero-pelvic junction obstruction. Afr J Urol. 2021;27:17. doi: 10.1186/s12301-021-00121-5.
- Yin H, Liang W, Zhao D. The application value of the renal region of interest corrected by computed tomography in single-kidney glomerular filtration rate for the evaluation of patients with moderate or severe hydronephrosis. Front Physiology. 2022;13:861895. doi: 10.3389/fphys.2022.861895
- Page MJ, McKenzie JE, Bossuyt PM, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372(71). doi: 10.1136/bmj.n71
- All-Russian public organization “Russian Society of Urology”. Klinicheskie rekomendatsii: Gidronefroz. 2023 [cited 2023 May 16]. Available from: https://cr.minzdrav.gov.ru/recomend/17_2 (In Russ.)
- Onen A. Grading of hydronephrosis: an ongoing challenge. Front Pediatr. 2020;8:458. doi: 10.3389/fped.2020.00458
- Babu R, Rathish VR. Functional outcomes of early versus delayed pyeloplasty in prenatally diagnosed pelvi-ureteric junction obstruction. J Pediatr Urol. 2015;11(2):63.e1–63.e5. doi: 10.1016/j.jpurol.2014.10.007
- Menon P, Rao KLN., Bhattacharya A, Mittal BR. Outcome analysis of pediatric pyeloplasty in units with less than 20 % differential renal function. J Pediatr Urol. 2016;12(3):171.e.1–171.e.7. doi: 10.1016/j.jpurol.2015.12.013
- Kim S-O, Song HY, Hwang IS, et al. Early pyeloplasty for recovery of parenchymal thickness in children with unilateral ureteropelvic junction obstruction. Urol Int. 2014;92(4):473–476. doi: 10.1159/000357144
- Tabari AK, Atqiaee K, Mohajerzadeh L, et al. Early pyeloplasty versus conservative management of severe ureteropelvic junction obstruction in asymptomatic infants. J Pediatr Surg. 2019;55(9):1936–1940. doi: 10.1016/j.jpedsurg.2019.08.006
- Has R, Sivrikoz TS. Prenatal diagnosis and findings in ureteropelvic junction type hydronephrosis. Front Pediatr. 2020;8:492. doi: 10.3389/fped.2020.00492
- Mello MF, Dos Reis ST, Kondo EY, et al. Urinary extracellular matrix proteins as predictors of the severity of ureteropelvic junction obstruction in children. J Pediatr Urol. 2021;17(4): 438.e1–438.e7. doi: 10.1016/j.jpurol.2021.03.017
- Roth DR, Gonzales ET, Jr. Management of ureteropelvic junction obstruction in infants. J Urol. 1983;129(1):108–110. doi: 10.1016/s0022-5347(17)51945-x
- Vemulakonda VM, Wilcox DT, Combleholme TM, et al. Factors associated with age at pyeloplasty in children with ureteropelvic junction obstruction. Pediatr Surg. 2015;31(9):871–877. doi: 10.1007/s00383-015-3748-2
- Onen A. An alternative hydronephrosis grading system to refine the criteria for exact severity of hydronephrosis and optimal treatment guidelines in neonates with primary UPJ-type hydronephrosis. J Pediatr Urol. 2007;3(3):200–205. doi: 10.1016/j.jpurol.2006.08.002
- Onen A. Üreteropelvik bileşke darligi. Çocuk Cerrahisi Dergisi. 2016;30(2):55–79. doi: 10.5222/JTAPS.2016.055 (In Turkish)
- Onen A, Yalinkaya A. Possible predictive factors for a safe prenatal follow-up of fetuses with hydonephrosis. The 29th Congress of European Society of Pediatric Urology. 11–14 April. Helsinki: ESPU; 2018.
- Smail LC, Dhindsa K, Braga LH, et al. Using deep learning algorithms to grade hydronephrosis severity: toward a clinical adjunct. Front Pediatr. 2020;8:1. doi: 10.3389/fped.2020.00001.
- Timberlake MD, Herndon CDA. Mild to moderate postnatal hydronephrosis grading systems and management. Nat Rev Urol. 2013;10(11):649–656. doi: 10.1038/nrurol.2013.172
- Chertin B, Rolle U, Farkas A, Puri P. Does delaying pyeloplasty affect renal function in children with a prenatal diagnosis of pelvi-ureteric junction obstruction? BJUI. 2002;90(1):72–75. doi: 10.1046/j.1464-410x.2002.02829.x
- Inker LA, Okparavero A. Cystatin C as a marker of glomerular filtration rate: prospects and limitations. Curr Opin Nephrol Hypertens. 2019;20(6):631–639. doi: 10.1097/MNH.0b013e32834b8850
- Parvex P, Combescure C, Rodriguez M, Girardin E. Is cystatin C a promisingmarker of renal function, at birth, in neonates prenatally diagnosed with congenital kidney anomalies? Nephrology Dialysis Transplantation. 2016;27(9):3477–3482. doi: 10.1093/ndt/gfs051
- Spasov SA. Opredelenie β2-mikroglobulina v krovi i moche pri anomaliyakh pochek. Radiology and practice. 2005;1:18–21 (In Russ.)
- Paraboschi I, Mantica G, Dalton NR, Turner C, Garriboli M. Urinary biomarkers in pelvic-ureteric junction obstruction: a systematic review. TAU. 2020;9(2):722–742. doi: 10.21037/tau.2020.01.01
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