Zhang L.a,b· Xu H.c· Feng Y.b· Wang X.b· Du G.b· Wu R.b· Liu W.b

Author affiliations

aDepartment of Minimally Invasive Urology, Jinan Children’s Hospital, Jinan, China
bDepartment of Pediatric Surgery, Shandong Provincial Hospital, Shandong First Medical University, Jinan, China
cDepartment of Pediatric Surgery, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China

Log in to MyKarger to check if you already have access to this content.

Buy FullText & PDF Unlimited re-access via MyKarger Unrestricted printing, no saving restrictions for personal use read more

CHF 38.00 *
EUR 35.00 *
USD 39.00 *

Select

KAB

Buy a Karger Article Bundle (KAB) and profit from a discount!

If you would like to redeem your KAB credit, please log in.

Save over 20% compared to the individual article price.

Learn more

Rent via DeepDyve Unlimited fulltext viewing of this article Organize, annotate and mark up articles Printing and downloading restrictions apply

Start free trial

Subscribe Access to all articles of the subscribed year(s) guaranteed for 5 years Unlimited re-access via Subscriber Login or MyKarger Unrestricted printing, no saving restrictions for personal use read more

Subcription rates

Select

* The final prices may differ from the prices shown due to specifics of VAT rules.

Article / Publication Details

First-Page Preview

Received: June 02, 2022
Accepted: December 22, 2022
Published online: March 23, 2023

Number of Print Pages: 6
Number of Figures: 0
Number of Tables: 5

ISSN: 0042-1138 (Print)
eISSN: 1423-0399 (Online)

For additional information: https://www.karger.com/UIN

Abstract

Introduction: This study aimed to analyze the changes in differential renal function (DRF) after laparoscopic pyeloplasty in children with high-grade hydronephrosis and factors influencing DRF improvement. Methods: We reviewed the clinical data of unilateral ureteropelvic junction obstruction (UPJO) patients with SFU grade IV who underwent laparoscopic pyeloplasty between February 2018 and October 2020. The patients were divided into two groups: DRF improvement ≥5% (group 1) and DRF improvement <5% (group 2). Preoperative, operative, and postoperative parameters were included in the statistical analysis in both groups. Results: A total of 29 patients with a median age of 6 months were included. The preoperative DRF in group 1 was significantly lower than that in group 2 (36.97 ± 8.47% vs. 45.19 ± 5.22%, p = 0.004). Logistic regression and receiver operating characteristic analysis showed the preoperative DRF was the predictor for renal function improvement after pyeloplasty (p = 0.021) and had a significant predictive value (p = 0.004). Conclusion: Nearly half of the patients with high-grade UPJO had improved renal function at 1 year follow-up after laparoscopic pyeloplasty. Preoperative DRF was a predictor of renal function improvement, and postoperative functional recovery was superior in children with lower preoperative DRF.

© 2023 S. Karger AG, Basel

References Nguyen HT, Herndon CDA, Cooper C, Gatti J, Kirsch A, Kokorowski P, et al. The Society for Fetal Urology consensus statement on the evaluation and management of antenatal hydronephrosis. J Pediatr Urol. 2010;6(3):212–31. Kim SO, Yu HS, Hwang IS, Hwang EC, Kang TW, Kwon D. Early pyeloplasty for recovery of parenchymal thickness in children with unilateral ureteropelvic junction obstruction. Urol Int. 2014;92(4):473–6. Zamfir Snykers C, De Plaen E, Vermersch S, Lopez M, Khelif K, Luyckx S, et al. Is laparoscopic pyeloplasty for ureteropelvic junction obstruction in infants under 1 year of age a good option? Front Pediatr. 2019;7:352. McAleer IM, Kaplan GW. Renal function before and after pyeloplasty: does it improve? J Urol. 1999;162(3 Pt 2):1041–4. Chipde SS, Lal H, Gambhir S, Kumar J, Srivastava A, Kapoor R, et al. Factors predicting improvement of renal function after pyeloplasty in pediatric patients: a prospective study. J Urol. 2012;188(1):262–5. Harraz AM, Helmy T, Taha DE, Shalaby I, Sarhan O, Dawaba M, et al. Changes in differential renal function after pyeloplasty in children. J Urol. 2013;190(4 Suppl):1468–73. Nordenström J, Koutozi G, Holmdahl G, Abrahamsson K, Sixt R, Sjöström S. Changes in differential renal function after pyeloplasty in infants and children. J Pediatr Urol. 2020;16(3):329.e1–8. Chandrasekharam VV, Srinivas M, Bal CS, Gupta AK, Agarwala S, Mitra DK, et al. Functional outcome after pyeloplasty for unilateral symptomatic hydronephrosis. Pediatr Surg Int. 2001;17(7):524–7. Xu G, Xu M, Ma J, Chen Z, Jiang D, Hong Z, et al. An initial differential renal function between 35% and 40% has greater probability of leading to normal after pyeloplasty in patients with unilateral pelvic-ureteric junction obstruction. Int Urol Nephrol. 2017;49(10):1701–6. Jiang D, Tang B, Xu M, Lin H, Jin L, He L, et al. Functional and morphological outcomes of pyeloplasty at different ages in prenatally diagnosed Society of Fetal Urology grades 3-4 ureteropelvic junction obstruction: is it safe to wait? Urology. 2017;101:45–9. Carpenter CP, Tolley E, Tourville E, Sharadin C, Giel DW, Gleason JM. Hydronephrosis after pyeloplasty: “will it go away?” Urology. 2018;121:158–63. Castagnetti M, Novara G, Beniamin F, Vezzú B, Rigamonti W, Artibani W. Scintigraphic renal function after unilateral pyeloplasty in children: a systematic review. BJU Int. 2008;102(7):862–8. Gnech M, Berrettini A, Lopes RI, Moscardi P, Esposito C, Zucchetta P, et al. Pyeloplasty vs. nephrectomy for ureteropelvic junction obstruction in poorly functioning kidneys (differential renal function <20%): a multicentric study. J Pediatr Urol. 2019;15(5):553.e1–8. Matsumoto F, Shimada K, Kawagoe M, Matsui F, Nagahara A. Delayed decrease in differential renal function after successful pyeloplasty in children with unilateral antenatally detected hydronephrosis. Int J Urol. 2007;14(6):488–90. Faure A, London K, Smith GHH. Early mercaptoacetyltriglycine(MAG-3) diuretic renography results after pyeloplasty. BJU Int. 2016;118(5):790–6. Salem YH, Majd M, Rushton HG, Belman AB. Outcome analysis of pediatric pyeloplasty as a function of patient age, presentation and differential renal function. J Urol. 1995;154(5):1889–93. Almodhen F, Jednak R, Capolicchio JP, Eassa W, Brzezinski A, El-Sherbiny M. Is routine renography required after pyeloplasty? J Urol. 2010;184(3):1128–33. Chandrasekharam VVS, Babu R, Arlikar J, Satyanarayana R, Murali Krishna N. Functional outcomes of pediatric laparoscopic pyeloplasty: post-operative functional recovery is superior in infants compared to older children. Pediatr Surg Int. 2021;37(8):1135–9. Cerrolaza JJ, Peters CA, Martin AD, Myers E, Safdar N, Linguraru MG. Quantitative ultrasound for measuring obstructive severity in children with hydronephrosis. J Urol. 2016;195(4 Pt 1):1093–9. Walker MR, Babikian S, Ernest AJ, Koch TS, Lustik MB, Rooks VJ, et al. Sonographic evaluation of hydronephrosis in the pediatric population: is well-tempered sonography necessary? J Ultrasound Med. 2015;34(4):655–62. Helmy TE, Harraz A, Sharaf DE, El Demerdash Y, Hafez AT, Gad H, et al. Can renal ultrasonography predict early success after pyeloplasty in children? a prospective study. Urol Int. 2014;93(4):406–10. Shokeir AA, El-Sherbiny MT, Gad HM, Dawaba M, Hafez AT, Taha MA, et al. Postnatal unilateral pelviureteral junction obstruction: impact of pyeloplasty and conservative management on renal function. Urology. 2005;65(5):980–5; discussion 985. Chertin B, Rolle U, Farkas A, Puri P. Does delaying pyeloplasty affect renal function in children with a prenatal diagnosis of pelvi-ureteric junction obstruction? BJU Int. 2002;90(1):72–5. Sarhan O, Al Otay A, Al Faddagh A, El Helaly A, Al Hagbani M, Al Ghanbar M, et al. Pyeloplasty in children with low differential renal function: functional recoverability. J Pediatr Urol. 2021;17(5):658.e1–9. Menon P, Rao KLN, Bhattacharya A, Mittal BR. Outcome analysis of pediatric pyeloplasty in units with less than 20% differential renal function. J Pediatr Urol. 2016;12(3):171.e1–7. Wagner M, Mayr J, Häcker FM. Improvement of renal split function in hydronephrosis with less than 10 % function. Eur J Pediatr Surg. 2008;18(3):156–9. Article / Publication Details

First-Page Preview

Received: June 02, 2022
Accepted: December 22, 2022
Published online: March 23, 2023

Number of Print Pages: 6
Number of Figures: 0
Number of Tables: 5

ISSN: 0042-1138 (Print)
eISSN: 1423-0399 (Online)

For additional information: https://www.karger.com/UIN

Copyright / Drug Dosage / Disclaimer Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.