Pyeloplasty and predictors in children with hydronephrosis

Abstract

Objective To assess the specific preoperative renal scintigraphic, ultrasonographic and other potential factors in predicting renal function outcomes after pyeloplasty. Methods After excluding those with renal anomalies, solitary kidney or bilateral hydronephrosis, a total of 213 children undergoing pyeloplasty between March 2008 and August 2012 were retrospectively reviewed. Preoperative renal scintigraphy, magnetic resonance urography and ultrasonography and postoperative scintigraphy were performed. Primary outcome measures were >5% improvement in baseline differential renal function and baseline weighted differential renal function at the follow-ups. And such clinical variables as gender, laterality, operative age, baseline differential renal function (DRF), preoperative renogram and degree of hydronephrosis in predicting outcomes were determined by multivariable analyses. Results During a mean follow-up period of 8.95 months, mean SD differential renal function improved from 32.61%±14.09% to 40.43%±11.32% (P 5% improvement in postoperative DRF. Conclusions DRF improves after pyeloplasty in children with hydronephrosis. And baseline DRF, operative age and degree of hydronephrosis may predict the extent of postoperative improvements. Key words: Hydronephrosis; Obstruction at ureteropelvic junction; Regression analysis