Outcome and management of isolated severe renal pelvis dilatation detected at postnatal screening
| Autor: | Mami', Carmelo, Paolata, A., Palmara, A., Marrone, T., Berte, L. F., Marseglia, LUCIA MARINA, Arena, Francesco, Manganaro, Rosa |
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| Jazyk: | angličtina |
| Rok vydání: | 2010 |
| Předmět: |
Male
Nephrology medicine.medical_specialty Urinary system Urology urologic and male genital diseases Rate ratio Vesicoureteral reflux hydronephrosis Internal medicine medicine Humans Kidney Pelvis Antibiotic prophylaxis Vesico-Ureteral Reflux business.industry Incidence (epidemiology) Infant medicine.disease Confidence interval Surgery Treatment Outcome medicine.anatomical_structure Urinary Tract Infections Pediatrics Perinatology and Child Health Female Kidney Diseases business Renal pelvis Dilatation Pathologic |
| Popis: | The aim of this study was to evaluate the incidence and outcome of isolated moderate renal pelvis dilatation (RPD) [anterior–posterior diameter (APD) 10–15 mm] in an unselected population of 2-month-old infants prospectively followed for up to 12–14 months of life. Isolated moderate renal pelvis dilatation was detected in 282 of the 11,801 (2.4%), infants screened; 240 infants with normal renal ultrasound were enrolled as the control group. Resolution of RPD was considered when an APD ≤ 5 mm was found on two consecutive sonograms. Urological investigations were initiated if the RPD persisted or if urinary tract infection (UTI) occurred during follow-up, and antibiotic therapy was administered only when UTI occurred. The events of interest were resolution of the RPD, presence of uropathy and UTI. At follow-up, RPD persisted only in 18 infants; of these, four infants were diagnosed with vesicoureteral reflux (grade 1–3) and 14 with ureteropelvic junction obstruction. Of the 223 infants with RPD and 230 control infants who completed follow-up, UTI occurred in 3.6 and 2.5%, respectively. The incidence rate of UTI per 1000 person-months was 5.98 episodes in the patient group and 5.22 episodes in the control group. The rate ratio was 1.146 (95% confidence interval 0.389–3.54, p = 0.8). Our data suggest that isolated moderate RPD is essentially a self-limiting condition and that antibiotic prophylaxis for the prevention of UTI should not be performed. A non-invasive ultrasound scan performed during the follow-up is sufficient to diagnose a potentially dangerous and persistent RPD. |
| Databáze: | OpenAIRE |
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