Lin Ziyong,Yang Yi,Yin Xiaoming,et al.Analysis of influencing factors and predictive modeling of renal function in children with hydronephrosis[J].Journal of Clinical Pediatric Surgery,,21():156-161.[doi:10.3760/cma.j.cn.101785-202012071-011]
Analysis of influencing factors and predictive modeling of renal function in children with hydronephrosis
- Keywords:
- Hydronephrosis/DG; Kidney Pelvis/AB; Renal Insufficiency; Ultrasonography; Child
- Abstract:
- Objective To explore the influencing factors of changes in renal function of children with hydronephrosis after pyeloneoplasty and establish a model for predicting the changes of renal function.Methods From January 1, 2011 to August 1, 2017, a retrospective review was conducted for 136 children with unilateral hydronephrosis.The relationship was examined between preoperative differential renal function (DRF), preoperative renal aspect ratio and postoperative DRF.Postoperative DRF ≥ 45% was chosen as a criterion for normal postoperative DRF.And a prediction model of renal function change was constructed through binary Logistic regression.Sensitivity and specificity were calculated by receiver operating characteristic (ROC) curve.Results Preoperative anterioposterior diameter (APD) at affected side, preoperative renal calyx size at affected side, preoperative renal cortical thickness at affected side, preoperative ratio of renal cortical thickness at affected side to APD and postoperative DRF recovery had no correlation (P>0.05).Logistic regression analysis indicated that preoperative DRF at affected side (OR=1.151, 95%CI:1.093-1.212, P<0.01) and preoperative renal transverse diameter ratio (OR=2.565, 95%CI:1.237-5.322, P=0.011) were correlated with postoperative DRF recovery.The model formula Logit(P)=-5.846+0.141* preoperative DRF at affected side + 0.942* preoperative renal transverse diameter ratio could predict whether or not postoperative DRF was ≥ 45%.Area under curve (AUC), sensitivity, specificity, Youden index and critical value were 0.828, 80.8%, 70.7%, 0.515 and-5.322.AUC, sensitivity, specificity and cut-off values of predicting postoperative DRF ≥ 45% at affected side for preoperative DRF at affected side were 0.851, 75.6%, 77.6%, 0.532 and 40.56%.AUC, sensitivity, specificity, Youden index and cut-off value of preoperative DRF predicting postoperative DRF ≥ 45% were 0.610, 79.5%, 46.5%, 0.260 and 0.388.Conclusion Preoperative renal function and preoperative ratio of lateral renal diameter of affected side to unhealthy side may predict postoperative DRF ≥ 45%.Such a predictive model provides rationales for surgeons to select postoperative follow-up modes and predict the probability of normalized DRF in children with hydronephrosis.
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Memo
收稿日期:2020-12-31。
基金项目:辽宁省重点研发计划联合计划项目（2020JH 2/10300145）
通讯作者:杨屹,Email:yangy2@sj-hospital.org