2082657 Pitfalls In The Diagnosis of Renal Sonography

Objectives: Postnatal evaluation of vesicoureteral reflux (VUR) remains controversial in patients with antenatal hydronephrosis (HN). The objective of this study was to identify the significance of mild postnatal HN as a marker of VUR and its severity. Materials and Methods: Sonographic findings of 248 children (351 kidneys) with persistent postnatal HN were evaluated for the incidence and severity of primary VUR. Results: The majority of patients had mild (67.8%) HN, followed by moderate (27.6%) and severe (4.6%) HN. VUR was identified in 14.7% of patients with mild HN, 18.5% of patients with moderate HN, and 18.7% of patients with severe HN. About 11.44% of patients with mild HN had low-grade VUR, followed by moderate (45.71 %) and severe grades (42.85%). Conclusion: A large number (89%) of patients with mild HN had moderate to severe VUR. In this cohort, renal sonography was not a reliable method for the prediction of VUR and its severity in patients with mild postnatal HN. However, it was reliable for high grades of VUR. These results are limited due to the study design and the inability to generalize these findings. These results should be replicated across other multiple clinics, thereby recruiting more variety of patients, to validate these study recommendations.

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Renal Sonography for Placement and Monitoring of Ureteral Stents During Pregnancy

Journal of Endourology ◽

10.1089/end.1991.5.241 ◽

1991 ◽

Vol 5 (3) ◽

pp. 241-243 ◽

Cited By ~ 8

Author(s):

CLIFFORD D. GLUCK ◽

CAROL B. BENSON ◽

ALBERT L. BUNDY ◽

CHRISTOPHER I. DOYLE ◽

KEVIN R. LOUGHLIN

Keyword(s):

Ureteral Stents ◽

Renal Sonography

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Reduced nephron endowment in the neonates of Indigenous Australian peoples

Journal of Developmental Origins of Health and Disease ◽

10.1017/s2040174413000494 ◽

2013 ◽

Vol 5 (1) ◽

pp. 31-35 ◽

Cited By ~ 10

Author(s):

Y. Kandasamy ◽

R. Smith ◽

I. M. R. Wright ◽

E. R. Lumbers

Keyword(s):

Blood Pressure ◽

Renal Function ◽

Filtration Rate ◽

Blood Pressure Measurement ◽

Tertiary Care ◽

Secondary Outcome ◽

Preterm Neonates ◽

Kidney Volume ◽

Nephron Number ◽

Renal Sonography

Rates of chronic kidney disease (CKD) among Indigenous groups in Australia exceed non-Indigenous rates eight-fold. Using kidney volume as a surrogate for nephron number, we carried out a study to determine if Indigenous neonates have a smaller kidney volume (and thus a reduced nephron number) from birth compared with non-Indigenous neonates. We recruited term and preterm neonates (<32 weeks) at a tertiary care neonatal unit over a 12 months period. Preterm neonates were assessed (renal sonography and renal function measurement) at 32 weeks corrected age (CA) and again at 38 weeks CA when blood pressure was also measured. All term neonates were assessed in the first post-natal week, including renal sonography, renal function and blood pressure measurement. The primary outcome measured was total kidney volume (TKV) and estimated glomerular filtration rate (eGFR) was a secondary outcome. Data was available for 44 preterm (11 Indigenous) and 39 term (13 Indigenous) neonates. TKV of Indigenous neonates was significantly lower at 32 weeks [12.0 (2.0)v.15.4 (5.1) ml;P=0.03] and 38 weeks CA [18.6 (4.0)v.22.6 (5.9) ml;P=0.04] respectively. Term Indigenous neonates also had smaller kidney volumes compared with non-Indigenous neonates. Despite a smaller kidney volume (and reduced nephron number), Indigenous neonates did not have a significantly lower eGFR. Indigenous neonates achieve similar eGFRs to Non-Indigenous neonates, presumably through a higher single nephron filtration rate. This places Indigenous neonates at a greater risk of long-term kidney damage later in life.

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