title: Outcome and management of isolated moderate renal pelvis dilatation detected at postnatal screening.
abstract: The aim of this study was to evaluate the incidence and outcome of isolated moderate renal pelvis dilatation (RPD) [anterior-posterior diameter (APD) 10-15 mm] in an unselected population of 2-month-old infants prospectively followed for up to 12-14 months of life. Isolated moderate renal pelvis dilatation was detected in 282 of the 11,801 (2.4%), infants screened; 240 infants with normal renal ultrasound were enrolled as the control group. Resolution of RPD was considered when an APD <or= 5 mm was found on two consecutive sonograms. Urological investigations were initiated if the RPD persisted or if urinary tract infection (UTI) occurred during follow-up, and antibiotic therapy was administered only when UTI occurred. The events of interest were resolution of the RPD, presence of uropathy and UTI. At follow-up, RPD persisted only in 18 infants; of these, four infants were diagnosed with vesicoureteral reflux (grade 1-3) and 14 with ureteropelvic junction obstruction. Of the 223 infants with RPD and 230 control infants who completed follow-up, UTI occurred in 3.6 and 2.5%, respectively. The incidence rate of UTI per 1000 person-months was 5.98 episodes in the patient group and 5.22 episodes in the control group. The rate ratio was 1.146 (95% confidence interval 0.389-3.54, p = 0.8). Our data suggest that isolated moderate RPD is essentially a self-limiting condition and that antibiotic prophylaxis for the prevention of UTI should not be performed. A non-invasive ultrasound scan performed during the follow-up is sufficient to diagnose a potentially dangerous and persistent RPD.
authors: Department of Pediatric and Surgery Sciences, University of Messina, 98124 Messina, Italy. carmelo.mami@unime.it
authors: Carmelo
authors: C
authors: Mamì
authors: Antonina
authors: A
authors: Paolata
authors: Antonella
authors: A
authors: Palmara
authors: Teresa
authors: T
authors: Marrone
authors: Luca F
authors: LF
authors: Berte
authors: Lucia
authors: L
authors: Marseglia
authors: Francesco
authors: F
authors: Arena
authors: Rosa
authors: R
authors: Manganaro
mesh_terms: D004108:Dilatation, Pathologic / Q000150:complications / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007682:Kidney Pelvis / Q000000981:diagnostic imaging* / Q000473:pathology*; D008297:Male; D008403:Mass Screening; D014463:Ultrasonography; D014517:Ureteral Obstruction / Q000150:complications / Q000000981:diagnostic imaging / Q000453:epidemiology; D014552:Urinary Tract Infections / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology; D014718:Vesico-Ureteral Reflux / Q000150:complications / Q000000981:diagnostic imaging / Q000453:epidemiology