Abstract
Purpose. We seek to correlate conventional hydronephrosis (HN) grade and hydronephrosis index (HI). Methods. We examined 1207 hydronephrotic kidneys by ultrasound. HN was classified by Society of Fetal Urology guidelines. HN was then gauged using HI, a reproducible, standardized, and dimensionless measurement of renal area. We then calculated average HI for each HN grade. Results. Comparing HI to standard SFU HN grade, average HI is 89.3 for grade I; average HI is 83.9 for grade II; average HI is 73.0 for grade III; average HI is 54.6 for SFU grade IV. Conclusions. HI correlates well with SFU HN grade. The HI serves as a quantitative measure of HN. HI can be used to track HN over time. Versus conventional grading, HI may be more sensitive in defining severe (grades III and IV) HN, and in indicating resolving, stable, or worsening HN, thus providing more information for clinical decision-making and HN management.
Highlights
Ultrasound (US) has gained widespread acceptance and use in fetal and pediatric urology
In 1993, the Society for Fetal Urology (SFU) established a grading system based on renal sinus splitting patterns and dilation of the renal pelvis and calyces [2]
The average hydronephrosis index (HI) was calculated for each group of kidneys, in order to establish a correlation of HI to HN grade (Table 1)
Summary
Ultrasound (US) has gained widespread acceptance and use in fetal and pediatric urology. HN had previously been characterized in a fairly subjective manner as mild, moderate, and severe. In 1993, the Society for Fetal Urology (SFU) established a grading system based on renal sinus splitting patterns and dilation of the renal pelvis and calyces [2]. Though the SFU grading system has been widely accepted, it does have certain deficiencies— especially in differentiation of severe (grades III and IV) HN [3]. Serial assessment of HN by US, often used in clinical decision making, relies on this grading system to suggest improving, stable, or worsening HN. Others have suggested improvements or complementary approaches to the SFU grading system [3–5]; none has gained widespread popularity of use
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