Evaluation of the cases diagnosed with congenital hydronephrosis

SUMMARY Antenatal hydronephrosis is a condition regarded as diametre of renal pelvis transverse greater than 5 mm. Apart from being physiological, as it can be seen with anomalies, it can result in renal damage in children. There are studies related to detection of early-stage renal failure by serum cystatin C and Transforming Growth Factor. This study aims to identify the causes of congenital hydronephrosis, to determine the clinical progress and treatment from the point of congenital hydronephrosis and study the role of congenital hydronephrosis in renal damage. This study includes 70 patients applied to Adnan Menderes University Medical Faculty, Pediatric Nephrology Outpatient Clinic of Child Health and Diseases Department. The mean age of patients was 11-60 months and age range was 39.9 ± 22.3 months. Control group was formed of 20 children with similar characteristics. First diagnosis time, birth information, information about hydronephrosis, results of USG, MSUG, MAG 3, DMSA and surgical results if any collected from the file records were evaluated through retrospective scanning. Serum cystatin C and TGF-B levels of all cases were being studied by ELISA. Statistical evaluation is performed with t test, Mann-Whitney U test, chi-square test and spearman rank correlation test. 72.8% of 70 antenatal hydronephrosis cases in the study were male and 62.9% were diagnosed in the third trimester. In the follow up process, decreased renal pelvic diameter was found in 30% of the cases in ultrasound performed in 6 months and 17.1%. in 12 months. MSUG was done to 60% and DMS was done to 31.4% of the cases. 10% of the cases were received UPD, 7.1% VUR, 2.9% UVD and 1.4% PUVA treatment. It is found that %70,2 of 37 cases of hydronephrosis resolved spontaneously, 3 cases surgically and 42.8% were still present. Serum cystatin-C and serum TGF-β1 levels were higher than of the control group. Serum cystatin-C levels were significantly higher in boys than girls. Compared with age groups, there is a significantly higher positive correlation between serum cystatin-C and TGF-β1 levels after a year. In a small cohort of patients aged less than a year, serum cystatin-C and serum levels of TGF-β1 in the group of patients with an increased degree of hydronephrosis are significantly higher than the group with decreased degree. According to the findings of our study, despite % 70 of Antenatal hydronephrosis cases substantially underwent spontaneous resolution, patients still need to be monitored by USG and further examination should be conducted if needed in terms of renal damage and underlying pathology . measurement of serum cystatin-C and TGF-β1 in patients with Antenatal hydronephrosis can be used to detect renal damage. There needs to be a comprehensive study including adult age group on this subject.