title: Cortical transit time as a predictive marker of the need for surgery in children with pelvi-ureteric junction stenosis: preliminary study.
abstract: BACKGROUND
  Postnatal management of prenatally detected hydronephrosis remains controversial. It has been suggested that cortical transit time (CTT) could successfully predict deterioration in children with pelvi-ureteric junction (PUJ) obstruction. We decided to conduct a retrospective study in our hydronephrosis population to evaluate whether initial CTT was significantly correlated with the need for surgery.
  
  
  METHODS
  We reviewed the charts of all our patients managed for significant PUJ obstruction (>12 mm) between 2007 and 2010 and determined CTT retrospectively, on the first diuretic scan of each of these patients. We then determined the relationship between initial CTT and the need for surgery.
  
  
  RESULTS
  We identified 37 patients with hydronephrosis (pelvic size >12 mm) of which 26 were diagnosed prenatally. Out of 22 patients with an initial abnormal CTT, 20 underwent surgery. Out of 15 children with a normal initial CTT, 4 underwent surgery (OR 27.5 (IC95%: 4.3-174.9)).
  
  
  CONCLUSIONS
  Initial CTT could be a reliable prognostic factor for future evolution of renal function in children with hydronephrosis. CTT is easy to determine on diuretic renal scan. A prospective trial is being devised to confirm what role it could have in the management of children with hydronephrosis.
authors.affiliation: Department of Pediatric Surgery, CHU F Guyon, Bellepierre, Saint-Denis de La Réunion, Reunion Island, France. Electronic address: harper_luke@hotmail.com.
authors.forename: L
authors.initials: L
authors.lastname: Harper
authors.forename: D
authors.initials: D
authors.lastname: Bourquard
authors.forename: C
authors.initials: C
authors.lastname: Grosos
authors.forename: O
authors.initials: O
authors.lastname: Abbo
authors.forename: C
authors.initials: C
authors.lastname: Ferdynus
authors.forename: J L
authors.initials: JL
authors.lastname: Michel
authors.forename: O
authors.initials: O
authors.lastname: Dunand
authors.forename: F
authors.initials: F
authors.lastname: Sauvat
mesh_terms: D000293:Adolescent; D015415:Biomarkers / Q000378:metabolism; D002648:Child; D005260:Female; D006801:Humans; D006869:Hydronephrosis / Q000151:congenital* / Q000000981:diagnostic imaging / Q000378:metabolism / Q000601:surgery; D007223:Infant; D007231:Infant, Newborn; D007682:Kidney Pelvis / Q000000981:diagnostic imaging / Q000378:metabolism*; D008297:Male; D021782:Multicystic Dysplastic Kidney / Q000000981:diagnostic imaging / Q000378:metabolism / Q000601:surgery; D010865:Pilot Projects; D011237:Predictive Value of Tests; D011300:Preoperative Care / Q000379:methods; D011379:Prognosis; D011877:Radionuclide Imaging; D012189:Retrospective Studies; D017263:Technetium Tc 99m Mertiatide; D014513:Ureter / Q000000981:diagnostic imaging / Q000378:metabolism*; D014517:Ureteral Obstruction / Q000000981:diagnostic imaging / Q000378:metabolism / Q000601:surgery
chemical_list: D015415:Biomarkers; D017263:Technetium Tc 99m Mertiatide
keywords: Cortical transit; Diuretic scan; Hydronephrosis; Pelvi-ureteric junction; Prognostic marker