Evaluation of patients diagnosed with hydronephrosis in the first month of life and retrospective investigation of follow-up

Evaluation of Patients Diagnosed with Hydronephrosis in the First Month of Life and Retrospective Investigation of follow-up Baskent University Faculty of Medicine, Department of Child Health and Diseases, Thesis, Ankara, 2017 Objective: Antenatal hydronephrosis (ANH) is the most common renal abnormality in the prenatal period. Although ANH is a common abnormality, there is no consensus on the follow-up of hydronephrosis in postnatal period. Our aim is to investigate classification of etiologic causes, selection of imaging methods and timing of patients who have hydronephrosis within the first month of life in antenatal period or postnatal life. Material and method: The clinical data, laboratory features, imaging modalities, treatment and follow-up results of 200 children were evaluated retrospectively who were diagnosed ANH or hydronephrosis diagnosed in the first month of life at the Department of Pediatric Nephrology of Baskent University. Results: 156 boys, 44 girls patients were included in the study. Age on first referral median was 15 days. The median follow up period was found 10,1 months (min: 2,4 - max:71,2). 141 unilateral hydronephrosis, 59 bilateral hydronephrosis are detected. A total of 70 patients who were detected UTI in the first urine culture, 55 of them had ANH (p=0,000). It has been shown that antero-posterior (AP) diameter measurement in the 3rd trimester USG more than 8.85 mm within the 66.7% sensitivity and the 61.9% specificity, and also it has been shown that AP diameter measurement in the first month control USG more than 10.5mm with 57.1% sensitivity and the 68.7% specificity, is associated with the possibility of urologic anomaly. Temporary hydronephrosis in 158 patients (79%), ureteropelvic junction obstruction in 19 patients (9.5%), vesicoureteral reflux in 17 patients (8.5%), ureterovesical junction obstruction in 3 patients (1.5%), posterior uretral valv in 2 patients (1%) and multicyctic dysplastic kidney in one patient (0.5%) were detected. Conclusion:It is considered that only selected patients should undergo further examination and in the other patients, long-term follow-up with as few tests as possible is appropriate due to many reasons in the etiology of ANH may be subject to spontaneous regression without any intervention and without any harm to the health of the child. Key words: Hydronephrosis, antenatal hydronephrosis, postnatal follow-up.