Outcome of isolated antenatal hydronephrosis.
OBJECTIVE
To define the clinical outcome in isolated antenatal hydronephrosis (ANH), defined as pelviectasis without vesicoureteral reflux or urinary tract obstruction.


METHODS
We analyzed prospectively gathered data from patients with isolated ANH. Pelviectasis, graded using the anterior-posterior diameter reference criteria, was defined by the status of the more severely affected kidney. Urinary tract obstruction was ruled out by diethylenetriamine pentaacetic acid scan when clinically indicated. Statistical differences were analyzed using the McNemar and chi 2 tests.


RESULTS
Isolated ANH was defined in 63 patients. The first postnatal ultrasonogram (mean +/- SD age, 18.4 +/- 17.8 days) revealed resolution of ANH in 16 (25%), mild pelviectasis in 34 (54%), and moderate or severe pelviectasis in 13 (21%). Ultrasonogram at the last follow-up visit (23.3 +/- 14.8 months) in 57 patients demonstrated normal pelvic diameter or mild pelviectasis in 47 (82%) (P =.002). In the 13 patients with moderate or severe neonatal pelviectasis, severity decreased in 11 (85%). Deterioration of any grade of pelviectasis occurred in only 3 (5%) of 57 patients. Renal growth, measured by renal length, was normal in all 57 patients.


CONCLUSIONS
Isolated ANH resolves or improves in most patients during the first 2 years of life.
Cheng
Adam M
AM
Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario.
Phan
Veronique
V
Geary
Denis F
DF
Rosenblum
Norman D
ND
D015897:Comorbidity; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006869:Hydronephrosis / Q000000981:diagnostic imaging* / Q000453:epidemiology; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009864:Ontario; D011446:Prospective Studies; D012075:Remission, Spontaneous; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012737:Sex Factors; D016896:Treatment Outcome; D014463:Ultrasonography; D014552:Urinary Tract Infections / Q000000981:diagnostic imaging* / Q000453:epidemiology; D014718:Vesico-Ureteral Reflux / Q000000981:diagnostic imaging* / Q000453:epidemiology