Top

Published in:

01-02-2013 | Educational Review

Current management of antenatal hydronephrosis

Authors: Kleiton G. R. Yamaçake, Hiep T. Nguyen

Published in: Pediatric Nephrology | Issue 2/2013

Abstract

The strategy for the management of children with urinary tract anomalies has changed considerably as a result of the development of ultrasound equipment and techniques that allow for detailed fetal evaluation. Hydronephrosis is the most common urogenital anomaly detected, suggesting that an obstructive process may be potentially present. The goal of postnatal management is to identify and treat those patients whose renal function is at risk, while leaving alone the high percentage of patients who are at no risk of renal damage. This management involves a spectrum of radiological, medical, and surgical interventions for diagnosis, surveillance, and treatment. In this article, we review our current understanding of the natural history of antenatal hydronephrosis and its management.

Grisoni ER, Gauderer MW, Wolfson RN, Izant RJ Jr (1986) Antenatal ultrasonography: the experience in a high risk perinatal center. J Pediatr Surg 21:358–361PubMedCrossRef

Woodward M, Frank D (2002) Postnatal management of antenatal hydronephrosis. BJU Int 89:149–156PubMedCrossRef

Ismaili K, Hall M, Donner C, Thomas D, Vermeylen D, Avni FE (2003) Results of systematic screening for minor degrees of fetal renal pelvis dilatation in an unselected population. Am J Obstet Gynecol 188:242–246PubMedCrossRef

Lee RS, Cendron M, Kinnamon DD, Nguyen HT (2006) Antenatal hydronephrosis as a predictor of postnatal outcome: a meta-analysis. Pediatrics 118:586–593PubMedCrossRef

Ismaili K, Avni FE, Piepsz A, Wissing KM, Cochat P, Aubert D, Hall M (2004) Current management of infants with fetal renal pelvis dilation: a survey by French-speaking pediatric nephrologists and urologists. Pediatr Nephrol 19:966–971PubMedCrossRef

Corteville JE, Gray DL, Crane JP (1991) Congenital hydronephrosis: correlation of fetal ultrasonographic findings with infant outcome. Am J Obstet Gynecol 165:384–388PubMed

Wollenberg A, Neuhaus TJ, Willi UV, Wisser J (2005) Outcome of fetal renal pelvic dilatation diagnosed during the third trimester. Ultrasound Obstet Gynecol 25:483–488PubMedCrossRef

Coelho GM, Bouzada MC, Lemos GS, Pereira AK, Lima BP, Oliveira EA (2008) Risk factors for urinary tract infection in children with prenatal renal pelvic dilatation. J Urol 179:284–289PubMedCrossRef

Coelho GM, Bouzada MC, Pereira AK, Figueiredo BF, Leite MR, Oliveira DS, Oliveira EA (2007) Outcome of isolated antenatal hydronephrosis: a prospective cohort study. Pediatr Nephrol 22:1727–1734PubMedCrossRef

10.

Mandell J, Peters CA, Retik AB (1998) Perinatal urology. Campbells urology, 7th edn. W.B.Saunders, Philadelphia

11.

Siemens DR, Prouse KA, MacNeily AE, Sauerbrei EE (1998) Antenatal hydronephrosis: thresholds of renal pelvic diameter to predict insignificant postnatal pelviectasis. Tech Urol 4:198–201PubMed

12.

Fernbach SK, Maizels M, Conway JJ (1993) Ultrasound grading of hydronephrosis: introduction to the system used by the Society for Fetal Urology. Pediatr Radiol 23:478–480PubMedCrossRef

13.

Lim DJ, Park JY, Kim JH, Paick SH, Oh SJ, Choi H (2003) Clinical characteristics and outcome of hydronephrosis detected by prenatal ultrasonography. J Korean Med Sci 18:859–862PubMed

14.

Phan V, Traubici J, Hershenfield B, Stephens D, Rosenblum ND, Geary DF (2003) Vesicoureteral reflux in infants with isolated antenatal hydronephrosis. Pediatr Nephrol 18:1224–1228PubMedCrossRef

15.

Gloor JM (1995) Management of prenatally detected fetal hydronephrosis. Mayo Clin Proc 70:145–152PubMedCrossRef

16.

Kitagawa H, Pringle KC, Stone P, Flower J, Murakami N, Robinson R (1998) Postnatal follow-up of hydronephrosis detected by prenatal ultrasound: the natural history. Fetal Diagn Ther 13:19–25PubMedCrossRef

17.

Nguyen HT, Herndon CD, Cooper C, Gatti J, Kirsch A, Kokorowski P, Lee R, Perez-Brayfield M, Metcalfe P, Yerkes E, Cendron M, Campbell JB (2010) The Society for Fetal Urology consensus statement on the evaluation and management of antenatal hydronephrosis. J Pediatr Urol 6:212–231PubMedCrossRef

18.

Oliveira EA, Rabelo EA, Pereira AK, Diniz JS, Cabral AC, Leite HV, Silva JM, Fagundes TA (2002) Prognostic factors in prenatally-detected posterior urethral valves: a multivariate analysis. Pediatr Surg Int 18:662–667PubMed

19.

Mure PY, Mouriquand P (2008) Upper urinary tract dilatation: prenatal diagnosis, management and outcome. Semin Fetal Neonatal Med 13:152–163PubMedCrossRef

20.

Shipp TD, Nguyen HT, Bromley B, Lyons JG, Benacerraf BR (2011) Importance of renal abnormalities first identified in the third trimester after normal findings on a detailed second-trimester structural fetal survey. J Ultrasound Med 30:1567–1572PubMed

21.

Herndon CD, Ferrer FA, Freedman A, McKenna PH (2000) Consensus on the prenatal management of antenatally detected urological abnormalities. J Urol 164:1052–1056PubMedCrossRef

22.

Holmes N, Harrison MR, Baskin LS (2001) Fetal surgery for posterior urethral valves: long-term postnatal outcomes. Pediatrics 108:E7PubMedCrossRef

23.

Spitzer A (1996) The current approach to the assessment of fetal renal function: fact or fiction? Pediatr Nephrol 10:230–235PubMedCrossRef

24.

Laing FC, Burke VD, Wing VW, Jeffrey RB Jr, Hashimoto B (1984) Postpartum evaluation of fetal hydronephrosis: optimal timing for follow-up sonography. Radiology 152:423–424PubMed

25.

Dejter SW Jr, Gibbons MD (1989) The fate of infant kidneys with fetal hydronephrosis but initially normal postnatal sonography. J Urol 142:661–662, discussion 667-668PubMed

26.

Conway JJ, Maizels M (1992) The "well tempered" diuretic renogram: a standard method to examine the asymptomatic neonate with hydronephrosis or hydroureteronephrosis. A report from combined meetings of The Society for Fetal Urology and members of The Pediatric Nuclear Medicine Council—The Society of Nuclear Medicine. J Nucl Med 33:2047–2051PubMed

27.

Perez-Brayfield MR, Kirsch AJ, Jones RA, Grattan-Smith JD (2003) A prospective study comparing ultrasound, nuclear scintigraphy and dynamic contrast enhanced magnetic resonance imaging in the evaluation of hydronephrosis. J Urol 170:1330–1334PubMedCrossRef

28.

Ismaili K, Avni FE, Hall M (2002) Results of systematic voiding cystourethrography in infants with antenatally diagnosed renal pelvis dilation. J Pediatr 141:21–24PubMedCrossRef

29.

Mandell J, Blyth BR, Peters CA, Retik AB, Estroff JA, Benacerraf BR (1991) Structural genitourinary defects detected in utero. Radiology 178:193–196PubMed

30.

Matsui F, Shimada K, Matsumoto F, Takano S (2008) Late recurrence of symptomatic hydronephrosis in patients with prenatally detected hydronephrosis and spontaneous improvement. J Urol 180:322–325, discussion 325PubMedCrossRef

31.

Gatti JM, Broecker BH, Scherz HC, Perez-Brayfield MR, Kirsch AJ (2001) Antenatal hydronephrosis with postnatal resolution: how long are postnatal studies warranted? Urology 57:1178CrossRef

32.

Koff SA, Campbell K (1992) Nonoperative management of unilateral neonatal hydronephrosis. J Urol 148:525–531PubMed

33.

Docimo SG, Silver RI (1997) Renal ultrasonography in newborns with prenatally detected hydronephrosis: why wait? J Urol 157:1387–1389PubMedCrossRef

34.

Riccabona M, Avni FE, Blickman JG, Dacher JN, Darge K, Lobo ML, Willi U (2008) Imaging recommendations in paediatric uroradiology: minutes of the ESPR workgroup session on urinary tract infection, fetal hydronephrosis, urinary tract ultrasonography and voiding cystourethrography, Barcelona, Spain, June 2007. Pediatr Radiol 38:138–145PubMedCrossRef

35.

van Eerde AM, Meutgeert MH, de Jong TP, Giltay JC (2007) Vesico-ureteral reflux in children with prenatally detected hydronephrosis: a systematic review. Ultrasound Obstet Gynecol 29:463–469PubMedCrossRef

36.

Passerotti CC, Kalish LA, Chow J, Passerotti AM, Recabal P, Cendron M, Lee RS, Lopez AB, Retik AB, Nguyen HT (2011) The predictive value of the first postnatal ultrasound in children with antenatal hydronephrosis. J Pediatr Urol 7:128–136PubMedCrossRef

37.

Sidhu G, Beyene J, Rosenblum ND (2006) Outcome of isolated antenatal hydronephrosis: a systematic review and meta-analysis. Pediatr Nephrol 21:218–224PubMedCrossRef

38.

Signorelli M, Cerri V, Taddei F, Groli C, Bianchi UA (2005) Prenatal diagnosis and management of mild fetal pyelectasis: implications for neonatal outcome and follow-up. Eur J Obstet Gynecol Reprod Biol 118:154–159PubMedCrossRef

39.

Odibo AO, Raab E, Elovitz M, Merrill JD, Macones GA (2004) Prenatal mild pyelectasis: evaluating the thresholds of renal pelvic diameter associated with normal postnatal renal function. J Ultrasound Med 23:513–517PubMed

40.

Brophy MM, Austin PF, Yan Y, Coplen DE (2002) Vesicoureteral reflux and clinical outcomes in infants with prenatally detected hydronephrosis. J Urol 168:1716–1719, discussion 1719PubMedCrossRef

41.

Farhat W, McLorie G, Geary D, Capolicchio G, Bagli D, Merguerian P, Khoury A (2000) The natural history of neonatal vesicoureteral reflux associated with antenatal hydronephrosis. J Urol 164:1057–1060PubMedCrossRef

42.

Vates TS, Shull MJ, Underberg-Davis SJ, Fleisher MH (1999) Complications of voiding cystourethrography in the evaluation of infants with prenatally detected hydronephrosis. J Urol 162:1221–1223PubMedCrossRef

43.

Fefer S, Ellsworth P (2006) Prenatal hydronephrosis. Pediatr Clin North Am 53:429–447, viiPubMedCrossRef

44.

Elder JS (1997) Antenatal hydronephrosis. Fetal and neonatal management. Pediatr Clin North Am 44:1299–1321PubMedCrossRef

45.

Penido Silva JM, Oliveira EA, Diniz JS, Bouzada MC, Vergara RM, Souza BC (2006) Clinical course of prenatally detected primary vesicoureteral reflux. Pediatr Nephrol 21:86–91PubMedCrossRef

46.

Estrada CR, Peters CA, Retik AB, Nguyen HT (2009) Vesicoureteral reflux and urinary tract infection in children with a history of prenatal hydronephrosis--should voiding cystourethrography be performed in cases of postnatally persistent grade II hydronephrosis? J Urol 181:801–806, discussion 806-807PubMedCrossRef

47.

Lee JH, Choi HS, Kim JK, Won HS, Kim KS, Moon DH, Cho KS, Park YS (2008) Nonrefluxing neonatal hydronephrosis and the risk of urinary tract infection. J Urol 179:1524–1528PubMedCrossRef

48.

Yavascan O, Aksu N, Anil M, Kara OD, Aydin Y, Kangin M, Cetinkaya E, Bal A (2010) Postnatal assessment of growth, nutrition, and urinary tract infections of infants with antenatally detected hydronephrosis. Int Urol Nephrol 42:781–788PubMedCrossRef

49.

Walsh TJ, Hsieh S, Grady R, Mueller BA (2007) Antenatal hydronephrosis and the risk of pyelonephritis hospitalization during the first year of life. Urology 69:970–974PubMedCrossRef

50.

Alconcher L, Tombesi M (2004) Mild antenatal hydronephrosis: management controversies. Pediatr Nephrol 19:819–820PubMedCrossRef

Title: Current management of antenatal hydronephrosis
Authors: Kleiton G. R. Yamaçake
Hiep T. Nguyen
Publication date: 01-02-2013
Publisher: Springer-Verlag
Published in: Pediatric Nephrology / Issue 2/2013
Print ISSN: 0931-041X
Electronic ISSN: 1432-198X
DOI: https://doi.org/10.1007/s00467-012-2240-7

ACC 2024 Congress

Springer Medicine

Current management of antenatal hydronephrosis

Abstract

ACC 2024 Congress

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 2/2013

Novel INF2 mutation p. L77P in a family with glomerulopathy and Charcot-Marie-Tooth neuropathy

An infant with hypercalcemia and rachitic changes: Question

The effect of vitamin E or vitamin A on the prevention of renal scarring in children with acute pyelonephritis

A comparison of arteriovenous fistulas and central venous lines for long-term chronic haemodialysis

Hyperlipidemia, oxidative stress, and intima media thickness in children with chronic kidney disease

Health-related quality of life functioning over a 2-year period in children with end-stage renal disease