Delayed decrease in differential renal function after successful pyeloplasty in children with unilateral antenatally detected hydronephrosis.
OBJECTIVE
The aim of this study was to evaluate functional outcome of congenital hydronephrotic kidney.


METHODS
The records of consecutive children who underwent pyeloplasty for unilateral prenatally detected ureteropelvic junction obstruction were reviewed. Renal function was assessed renographically before and after surgery. Mean follow-up period was 100 months.


RESULTS
Sufficient pre- and postoperative data were available for 60 children. Differential renal function (DRF) improved in 14 (23%) and decreased in nine (15%) of 60 patients in the early postoperative period. DRF improved in seven (18%) and decreased in 13 (34%) of 38 patients at the end of follow-up. Five of 14 patients with increased DRF at early postoperative scan returned to the preoperative level at the end of follow-up. No patients with decreased DRF at early postoperative scan showed any recovery in DRF and progressive decrease was seen in four of nine children.


CONCLUSIONS
The DRF was not stable in some patients after successful pyeloplasty. In some patients impairment of renal function came to be apparent with time. Improvement of DRF may be a transient phenomenon seen in the early postoperative period. To avoid overestimation of functional recovery, long-term follow-up with delayed renographic evaluation is recommended.
Matsumoto
Fumi
F
Department of Urology, Osaka Medical Center and Research Institute for Maternal and Child Health, Osaka, Japan. fumim@mch.pref.osaka.jp
Shimada
Kenji
K
Kawagoe
Mari
M
Matsui
Futoshi
F
Nagahara
Akira
A
D002675:Child, Preschool; D005500:Follow-Up Studies; D006801:Humans; D006869:Hydronephrosis / Q000151:congenital / Q000000981:diagnostic imaging / Q000601:surgery*; D007223:Infant; D007668:Kidney / Q000000981:diagnostic imaging / Q000502:physiology / Q000601:surgery*; D008499:Medical Records; D011183:Postoperative Complications / Q000000981:diagnostic imaging*; D011296:Prenatal Diagnosis; D011866:Radioisotope Renography; D016896:Treatment Outcome; D013520:Urologic Surgical Procedures