Natural course of isolated mild congenital hydronephrosis: A 2-year prospective study at a single center in Japan.

Abstract

To determine a follow-up plan for mild congenital hydronephrosis in Japanese individuals. Neonates at Kansai Medical University Hospital (Hirakata, Osaka, Japan) who were diagnosed with mild congenital hydronephrosis - defined as a Society for Fetal Urology grade1 or 2 - at 1-month old by abdominal ultrasonography between 2014 and 2016 were enrolled. These patients were encouraged to undergo repeated abdominal ultrasonography for 2years every 3months to investigate the course of congenital hydronephrosis. Among 1009 neonates, congenital hydronephrosis was detected in 118 affected renal units of 100 (9.9%) patients. According to the definition of the Society for Fetal Urology, 118 affected renal units were graded as grade1 in 87 (74%), grade2 in 30 (25%), grade3 in one (1%) and grade4 in 0 units. Among them, 117 affected renal units of mild congenital hydronephrosis comprising grades1 and 2 were subjected to ultrasonographic evaluation to monitor the natural course. The rates of resolution at 7, 10, 13, 16, 19, 22 and 25 months after birth in Society for Fetal Urology grades 1 and 2 cases were 60% and 8%, 77% and 19%, 90% and 32%, 92% and 40%, 95% and 52%, 96% and 56%, and 99% and 60%, respectively. Grade1 congenital hydronephrosis does not need to be followed up, because it mostly shows spontaneous resolution by 2years of follow up without any complications. However, ultrasonographic examinations at 1-year intervals for grade2 congenital hydronephrosis are recommended to determine the subsequent follow-up plan of patients.