title: Outcome and management of isolated severe renal pelvis dilatation detected at postnatal screening.
abstract: The aim of this study was to evaluate the incidence and outcome of isolated severe renal pelvis dilatation (RPD; APD>15<or=20 mm) in an unselected population of 2-month-old infants prospectively followed up for 12-14 months of life. Isolated severe renal pelvis dilatation was detected in 46 of the 11,801 (0.39%) infants screened. Nephro-urological investigations were initiated if RPD persisted, or if urinary tract infection (UTI) occurred during follow-up, and antibiotic therapy was administered only when UTI occurred. At follow-up, RPD persisted in 24 infants. Of these, 8 infants presented with vesico-ureteral reflux (VUR) of grade>or=3 and 16 with ureteropelvic junction obstruction (UPJO). Incidence of UTI was significantly higher (p<0.001) in infants of the study group than in infants of the control group (13.9 vs 2.5%). Our data suggest that isolated severe RPD may be a self-limiting condition and that antibiotic prophylaxis (AP) for the prevention of UTI should not be performed. Considering RDP resolution and the incidence of UTI during follow-up, investigations for uropathy in infants with isolated, severe RPD are justified in persistent cases, or when UTI occurs during follow-up. Careful clinical monitoring for signs of UTI and treatment of each episode of UTI may be sufficient and safe.
authors.affiliation: Department of Paediatric and Surgery Sciences, University of Messina, 98124, Messina, Italy. carmelo.mami@unime.it
authors.forename: Carmelo
authors.initials: C
authors.lastname: Mamì
authors.forename: Antonella
authors.initials: A
authors.lastname: Palmara
authors.forename: Antonina
authors.initials: A
authors.lastname: Paolata
authors.forename: Teresa
authors.initials: T
authors.lastname: Marrone
authors.forename: Lucia
authors.initials: L
authors.lastname: Marseglia
authors.forename: Luca F
authors.initials: LF
authors.lastname: Bertè
authors.forename: Francesco
authors.initials: F
authors.lastname: Arena
mesh_terms: D004108:Dilatation, Pathologic / Q000150:complications / Q000453:epidemiology; D005260:Female; D006801:Humans; D007223:Infant; D007674:Kidney Diseases / Q000150:complications* / Q000453:epidemiology; D007682:Kidney Pelvis / Q000002:abnormalities*; D008297:Male; D016896:Treatment Outcome; D014552:Urinary Tract Infections / Q000453:epidemiology / Q000209:etiology; D014718:Vesico-Ureteral Reflux / Q000453:epidemiology / Q000209:etiology