title: An analysis of long-term occurrence of renal complications following pediatric pyeloplasty.
abstract: OBJECTIVE
  Few reports discuss post-pubertal renal complications after pyeloplasty. We analyzed long-term complications, such as decreased renal function (RF) measured by serum creatinine (SCr), hypertension (HTN), or proteinuria (protU) following pediatric pyeloplasty.
  
  
  METHODS
  We retrospectively investigated 257 patients who underwent dismembered pyeloplasty due to ureteropelvic junction obstruction from January 1986 to December 2001. Medical history, preoperative and postoperative blood pressure, urinalysis, and SCr results were reviewed.
  
  
  RESULTS
  Fifty-five patients (47 male, 8 female) who were followed up for at least 10 years with post-pubertal follow-up data available were analyzed. Seven (12.7%) patients were diagnosed with HTN, and 10 (18.2%) with protU. The grade of hydronephrosis decreased, and the differential RF measured by MAG-3 renal scan significantly increased at final analysis (p<0.001). Presence of preoperative symptoms (p=0.034), and SCr elevation (p=0.018) showed correlation with HTN. HTN took 15.7 (±5.8) (7-25) years, and protU detection took 16.2 (±5.9) (6-23) years, with the highest incidence of both HTN and protU between 15 and 20 years postoperatively.
  
  
  CONCLUSIONS
  According to our investigation, a prudent evaluation of signs of RF decrease at 10 years after surgery, and then every 5 years, until 20 years should be recommended, although further studies are necessary.
authors.affiliation: Department of Urology, Gachon University Gil Medical Center, Seoul, South Korea.
authors.forename: Hahn-Ey
authors.initials: HE
authors.lastname: Lee
authors.affiliation: Department of Urology, The Armed Forces Medical Command, South Korea. Electronic address: urodori@naver.com.
authors.forename: Kwanjin
authors.initials: K
authors.lastname: Park
authors.affiliation: Department of Urology, The Armed Forces Medical Command, South Korea.
authors.forename: Hwang
authors.initials: H
authors.lastname: Choi
mesh_terms: D002675:Child, Preschool; D003401:Creatine / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000209:etiology; D015994:Incidence; D007682:Kidney Pelvis / Q000601:surgery*; D008297:Male; D011183:Postoperative Complications / Q000097:blood / Q000453:epidemiology* / Q000209:etiology; D011507:Proteinuria / Q000097:blood / Q000453:epidemiology / Q000209:etiology; D019651:Plastic Surgery Procedures / Q000009:adverse effects*; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D014517:Ureteral Obstruction / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000009:adverse effects*
chemical_list: D003401:Creatine
keywords: Creatinine; Follow-up studies; Hypertension; Proteinuria; Urologic surgical procedures