Zhang Junqi,Geng Hongquan.Recent advances in renal function evaluation and outcome prediction of pediatric hydronephrosis[J].Journal of Clinical Pediatric Surgery,,19():193-198.[doi:10.3969/j.issn.1671-6353.2020.03.001]
Recent advances in renal function evaluation and outcome prediction of pediatric hydronephrosis
- Keywords:
- Hydronephrosis; Ureteropelvic Junction Obstruction; Ultrasonography; Diuretic Renogram; Magnetic Resonance Imaging
- CLC:
- R726.9;R692.7;R445.1
- Abstract:
- Hydronephrosis of children are generally conservatively managed while surgical intervention is only indicated whenever necessary.However,the management protocol has remained controversial.The diagnostic and predictive values of multiple examinations and surgical indications and timing are not standardized.Examinations of hydronephrosis include ultrasound,diuretic renogram and magnetic resonance urography (MRU).Cut-off values,ratio/index,grading and scoring systems from observational analysis of clinical data help to define the requirements of surgery and the necessities of continuing observations.Currently none of the above modalities dominates prominently in sensitivity and specificity.Novel technology of data analysis such as machine learning has been applied for boosting the diagnostic and predictive capacities of ultrasound and renogram.Clinical application of urinary biomarker is also under exploration.We here reviewed and evaluated recent advances of different diagnostic methods in renal function estimation and outcome prediction.
References:
1 Coplen DE,Austin PF,Yan Y,et al.The magnitude of fetal renal pelvic dilatation can identify obstructive postnatal hydronephrosis,and direct postnatal evaluation and management[J].J Urol,2006,176(2):724-727.DOI:10.1016/j.juro.2006.03.079.
2 Dias CS,Silva JMP,Pereira AK,et al.Diagnostic accuracy of renal pelvic dilatation for detecting surgically managed ureteropelvic junction obstruction[J].J Urol,2013,190(2):661-666.DOI:10.1016/j.juro.2013.02.014.
3 Chipde SS,Lal H,Gambhir S,et al.Factors predicting improvement of renal function after pyeloplasty in pediatric patients:A prospective study[J].J Urol,2012,188(1):262-265.DOI:10.1016/j.juro.2012.03.023.
4 Rickard M,Braga LH,Oliveria JP,et al.Percent improvement in renal pelvis antero-posterior diameter (PI-APD):Prospective validation and further exploration of cut-off values that predict success after pediatric pyeloplasty supporting safe monitoring with ultrasound alone[J].J Pediatr Urol,2016,12(4):228.e1-228.e6.DOI:10.1016/j.jpurol.2016.04.003.
5 Romao RLP,Farhat WA,Pippi Salle JL,et al.Early postoperative ultrasound after open pyeloplasty in children with prenatal hydronephrosis helps identify low risk of recurrent obstruction[J].J Urol,2012,188(6):2347-2353.DOI:10.1016/j.juro.2012.08.036.
6 Babu R,Sai V.Pelvis/cortex ratio:an early marker of success following pyeloplasty in children[J].J Pediatr Urol,2010,6(5):473-476.DOI:10.1016/j.jpurol.2009.12.004.
7 Rickard M,Lorenzo AJ,Braga LH.Renal parenchyma to hydronephrosis area ratio (PHAR) as a predictor of future surgical intervention for infants with high-grade prenatal hydronephrosis[J].Urology,2017,101:85-89.DOI:10.1016/j.urology.2016.09.029.
8 Shapiro SR,Wahl EF,Silberstein MJ,et al.Hydronephrosis index:a new method to track patients with hydronephrosis quantitatively[J].Urology,2008,72(3):536-538.DOI:10.1016/j.urology.2008.02.007.
9 Imaji R,Dewan PA.Calyx to parenchyma ratio in pelvi-ureteric junction obstruction[J].BJU Int,2002,89(1):73-77.DOI:10.1046/j.1464-410x.2002.02543.x.
10 Braga LH,McGrath M,Farrokhyar F,et al.Society for Fetal Urology Classification vs Urinary Tract Dilation Grading System for Prognostication in Prenatal Hydronephrosis:A Time to Resolution Analysis[J].J Urol,2018,199(6):1615-1621.DOI:10.1016/j.juro.2017.11.077.
11 Braga LH,McGrath M,Farrokhyar F,et al.Associations of Initial Society for Fetal Urology Grades and Urinary Tract Dilatation Risk Groups with Clinical Outcomes in Patients with Isolated Prenatal Hydronephrosis[J].J Urol,2017,197(3):831-837.DOI:10.1016/j.juro.2016.08.099.
12 Onen A.An alternative grading system to refine the criteria for severity of hydronephrosis and optimal treatment guidelines in neonates with primary UPJ-type hydronephrosis[J].J Pediatr Urol,2007,3(3):200-205.DOI:10.1016/j.jpurol.2006.08.002.
13 Dos Santos J,Parekh RS,Piscione TD,et al.A new grading system for the management of antenatal hydronephrosis[J].Clin J Am Soc Nephrol,2015,10(10):1783-1790.DOI:10.2215/cjn.12861214.
14 Cerrolaza JJ,Peters CA,Martin AD,et al.Quantitative Ultrasound for Measuring Obstructive Severity in Children with Hydronephrosis[J].J Urol,2016,195(4):1093-1099.DOI:10.1016/j.juro.2015.10.173.
15 Ulman I,Jayanthi VR,Koff SA.The long-term followup of newborns with severe unilateral hydronephrosis initially treated nonoperatively[J].J Urol,2000,164(3 Pt 2):1101-1105.DOI:10.1097/00005392-200009020-00046.
16 Assmus MA,Kiddoo DA,Hung RW,et al.Initially asymmetrical function on MAG3 renography increases incidence of adverse outcomes[J].J Urol,2016,195(4 Part 2):1196-1202.
17 Sussman RD,Blum ES,Sprague BM,et al.Prediction of clinical outcomes in prenatal hydronephrosis:importance of gravity assisted drainage[J].J Urol,2017,197(3 Part 2):838-844.DOI:10.1016/j.juro.2016.09.111.
18 Arena S,Chimenz R,Antonelli E,et al.A long-term follow-up in conservative management of unilateral ureteropelvic junction obstruction with poor drainage and good renal function[J].Eur J Pediatr,2018,177(12):1761-1765.DOI:10.1007/s00431-018-3239-2.
19 Bayne CE,Majd M,Rushton HG.Diuresis renography in the evaluation and management of pediatric hydronephrosis:What have we learned?[J] J Pediatr Urol,2019,15(2):128-137.DOI:10.1016/j.jpurol.2019.01.011.
20 Blum ES,Porras AR,Biggs E,et al.Early Detection of Ureteropelvic Junction Obstruction Using Signal Analysis and Machine Learning:A Dynamic Solution to a Dynamic Problem[J].J Urol,2018,199(3):847-852.DOI:10.1016/j.juro.2017.09.147.
21 Rohrschneider WK,Haufe S,Wiesel M,et al.Functional and morphologic evaluation of congenital urinary tract dilatation by using combined static-dynamic MR urography:findings in kidneys with a single collecting system[J].Radiology,2002,224(3):683-694.DOI:10.1148/radiol.2243011207.
22 Perez-Brayfield MR,Kirsch AJ,Jones RA,et al.A prospective study comparing ultrasound,nuclear scintigraphy and dynamic contrast enhanced magnetic resonance imaging in the evaluation of hydronephrosis[J].J Urol,2003,170(4):1330-1334.DOI:10.1097/01.ju.0000086775.66329.00.
23 Claudon M,Durand E,Grenier N,et al.Chronic urinary obstruction:evaluation of dynamic contrast-enhanced MR urography for measurement of split renal function[J].Radiology,2014,273(3):801-812.DOI:10.1148/radiol.14131819.
24 Mitterberger M,Pinggera GM,Neururer R,et al.Comparison of contrast-enhanced color Doppler imaging (CDI),computed tomography (CT),and magnetic resonance imaging (MRI) for the detection of crossing vessels in patients with ureteropelvic junction obstruction (UPJO)[J].Eur Urol,2008,53(6):1254-1262.DOI:10.1016/j.eururo.2007.11.031.
25 Madsen MG,N?rregaard R,Palmfeldt J,et al.Epidermal growth factor and monocyte chemotactic peptide-1:potential biomarkers of urinary tract obstruction in children with hydronephrosis[J].J Pediatr Urol,2013,9(6):838-845.DOI:10.1016/j.jpurol.2012.11.011.
26 Wasilewska A,Taranta-Janusz K,Dkebek W,et al.KIM-1 and NGAL:new markers of obstructive nephropathy[J].Pediatr Nephrol,2011,26(4):579-586.DOI:10.1007/s00467-011-1773-5.
27 Papachristou F,Pavlaki A,Printza N.Urinary and serum biomarkers in ureteropelvic junction obstruction:a systematic review[J].Biomarkers,2014,19(7):531-540.DOI:10.3109/1354750x.2014.943292.
28 Chen H,Lin H,Xu M,et al.Quantitative Urinary Proteome Reveals Potential Biomarkers for Ureteropelvic Junction Obstruction[J].PROTEOMICS-Clinical Appl,2019,13(4):1800101.DOI:10.1002/prca.201800101.
29 Mesrobian H-GO,Mitchell ME,See WA,et al.Candidate urinary biomarker discovery in ureteropelvic junction obstruction:a proteomic approach[J].J Urol,2010,184(2):709-714.DOI:10.1016/j.juro.2010.03.061.
Memo
收稿日期:2019-12-27。
基金项目:上海市卫生系统优秀学科带头人培养计划(编号:2017BR061)
通讯作者:耿红全,Email:genghongquan@xinhuamed.com.cn