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Hafif ve Orta Dereceli İzole Antenatal Hidronefrozlu Süt Çocuklarının Postnatal İzlem Sonuçlarının Değerlendirilmesi

Yıl 2019, Cilt: 41 Sayı: 1, 17 - 22, 01.01.2019
https://doi.org/10.20515/otd.425849

Öz

Antenatal hidronefroz
doğum öncesi yapılan ultrasonografik incelemede en sık saptanan konjenital
ürolojik anomalilerden biridir. Hafif ve orta dereceli izole antenatal
hidronefrozun doğum sonrası dönemdeki yönetimi hakkında çelişkili sonuçlar
bulunmaktadır. Bu çalışmanın amacı hafif ve orta dereceli izole antenatal
hidronefrozlu süt çocuklarında ilk bir yılda idrar yolu enfeksiyonu (İYE)
sıklığını ve klinik seyri araştırmaktır. Bu çalışmaya doğum sonrası 7 gün ile 2
hafta arasında yapılan ilk böbrek ultrasonografisinde hafif ve orta dereceli
hidronefrozu olan hastalar dahil edildi. Hidronefroz dışında böbrek anomalisi
olan, üreteral dilatasyonu ya da mesane
anomalisi bulunan hastalar çalışmaya dahil edilmedi. Hidronefroz ön-arka pelvis
çapı ölçülerek hafif (5-9.9 mm) ve orta (10-14.9 mm) dereceli olarak
sınıflandırıldı. Çalışmaya 140 hasta
[96 erkek (%68.6), 44 kız (%31.4)] dahil edildi. Altmış hasta (%42.9) hafif
dereceli, 80 hasta (%57.1) orta dereceli hidronefroza sahipti. Spontan gerileme
oranı hafif hidronefrozlu hastalarda diğer gruptan daha yüksekti [sırası ile
n=58 (%96.6), n=48 (%60), p<0.01]. Ortanca gerileme zamanı hafif hidronefrozlu
hastalarda daha kısa idi [ortanca gerileme zamanı; sırası ile 4 (3-5.25); 6
(5-7) ay,  p<0.01]. İYE sıklığı hafif
ve orta dereceli hidronefrozlu hastalar arasında farklı değildi (p>0.05).
Hafif ve orta dereceli izole hidronefroz sıklıkla
kendini sınırlayan bir durumdur. Hafif ve orta dereceli izole hidronefrozlu
çocuklar antibiyotik profilaksisi başlanmadan izlenebilir.



 

Kaynakça

  • Referans1 Bozacı AC, Doğan HS, Tekgül S. Antenatal Hidronefroz. Turkiye Klinikleri J Urology-Special Topics 2015;8(4):7-13.
  • Referans2 Lee RS, Cendron M, Kinnamon DD, Nguyen H T. Antenatal hydronephrosis as a predictor of postnatal outcome: A meta-analysis. Pediatrics. 2006;118 (2): 586–93.
  • Referans3 Sidhu G, Beyene J, Rosenblum ND. Outcome of isolated antenatal hydronephrosis: a systematic review and metaanalysis. Pediatr Nephrol. 2006; 21(2): 218e24.
  • Referans4 Homsy YL, Saad F, Laberge I, Williot P, Pison C. Transitional hydronephrosis of the newborn and infant. J Urol. 1990;144(2 Pt 2):579e83.
  • Referans5 Ismaili K, Avni FE, Piepsz A, Wissing KM, Cochat P, Aubert D, et al. Current management of infants with fetal renal pelvis dilation: a survey by French-speaking pediatric nephrologists and urologists. Pediatr Nephrol. 2004;19(9):966–971.
  • Referans6 Shaikh N, Ewing AL, Bhatnagar S, Hoberman A. Risk of renal scarring in children with a first urinary tract infection: a systematic review. Pediatrics. 2010;126(6):1084-91.
  • Referans7 Williams GJ, Wei L, Lee A, Craig JC. Long-term antibiotics for preventing recurrent urinary tract infection in children. Cochrane Database Syst Rev. 2006;19(3):CD001534.
  • Referans8 Blachar A, Blachar Y, Livne PM, Zurkowski L, Pelet D, Mogilner B. Clinical outcome and follow-up of prenatal hydronephrosis. Pediatr Nephrol. 1994;8(1):30–35.
  • Referans9 Al-Shibli AI, Chedid F, Mirghani H, Al Safi W, Al-Bassam MK. The significance of fetal renal pelvic dilatation as a predictor of postnatal outcome. J Matern Fetal Neonatal Med. 2009; 22(9):797e800.
  • Referans10 Asl AS, Maleknejad S. Clinical outcome and follow-up of prenatal hydronephrosis. Saudi J Kidney Dis Transpl. 2012;23(3):526e31.
  • Referans11 Bak M, Tümay D, Serdaroğlu E. The postnatsl follow-up prenatally diagnosed diagnosed urinary anomalies cases. Turkiye Klinikleri J Pediatr 2007;16(4):255-63.
  • Referans12 Mami C, Paolata A, Palmara A, Marrone T, Berte LF, Marseglia L, et al. Outcome and management of isolated moderate renal pelvis dilatation detected at postnatal screening. Pediatr Nephrol. 2009;24(10):2005–2008.
  • Referans13 Sairam S, Al-Habib A, Sasson S, Thilaganathan B. Natural history of fetal hydronephrosis diagnosed on mid-trimester ultrasound. Ultrasound Obstet Gynecol. 2001;17(3):191–196.
  • Referans14 Mallik M, Watson AR. Antenatally detected urinary tract abnormalities: more detection but less action. Pediatr Nephrol. 2008;23(6):897–904.
  • Referans15 Tekin M, Gülyüz A, Özay C, Konca Ç. Postnatal Assessment and Outcome of Infants with Antenatal Hydronephrosis. Turkish J Pediatr Dis. 2016;2:96-100.
  • Referans16 Çamlar SA, Deveci N, Soylu A, Türkmen MA, Özmen D, Çapakaya G, et al. The role of dynamic renal scintigraphy on clinical decision making in hydronephrotic children. Saudi J Kidney Dis Transpl. 2017;28(1):76-80.
  • Referans17 Brenner DJ, Hall EJ. Computed tomography-An increasing source of radiation exposure. N Engl J Med. 2007;357(22):2277-84.
  • Referans18 Smith T, Gordon I. An update of radiopharmaceutical schedules in children. Nucl Med Communicat. 1998;19(11):1023-36.
  • Referans19 Easterbrook B, Capolicchio JP, Braga LH. Antibiotic prophylaxis for prevention of urinary tract infections in prenatal hydronephrosis: An updated systematic review. Can Urol Assoc J. 2017;11(1-2Suppl1): S3-11.
  • Referans20 Montini G, Tullus K, Hewitt I. Febrile urinary tract infections in children. N Engl J Med. 2011;365(3):239-50.
  • Referans21 Walsh TJ, Hsieh S, Grady R, Mueller BA. Antenatal hydronephrosis and the risk of pyelonephritis hospitalization during the first year of life. Urology 2007;69(5):970-4.
  • Referans22 Woodward M, Frank D. Postnatal management of antenatal hydronephrosis. BJU Int. 2002;89(2):149–156.
  • Referans23 Roth CC, Hubanks JM, Bright BC, Heinlen JE, Donovan BO, Kropp BP, et al. Occurrence of urinary tract infection in children with significant upper urinary tract obstruction. Urology 2009;73(1):74–78.
  • Referans24 Alconcher L, Tombesi M. Mild antenatal hydronephrosis: management controversies. Pediatr Nephrol. 2004;19(7):819–820.
  • Referans25 Lidefelt KJ, Herthelius M. Antenatal hydronephrosis: infants with minor postnatal dilatation do not need prophylaxis. Pediatr Nephrol. 2008;23(11):2021–2024.
  • Referans26 Braga LH, Mijovic H, Farrokhyar F, Pemberton J, DeMaria J, Lorenzo AJ. Antibiotic prophylaxis for urinary tract infections in antenatal hydronephrosis. Pediatrics 2013;131(1):e251.
  • Referans27 Elder JS. Commentary: importance of antenatal diagnosis of vesicoureteral reflux. J Urol. 1992(5 Pt 2);148:1750e4.
  • Referans28 Andrich M, Massoud M. Diagnostic imaging in the evaluation of first time urinary tract infection in infants and young children. Pediatrics 1992;90(3):436–41.
  • Referans29 Passerotti CC, Kalish LA, Chow J, Passerotti AM, Recabal P, Cendron M, et al. The predictive value of the first postnatal ultrasound in children with antenatal hydronephrosis. J Pediatr Urol. 2011;7(2):128-36.
  • Referans30 Yeung CK, Godley ML, Dhillon HK, Gordon I, Duffy PG, Ransley PG. The characteristics of primary vesico-ureteric reflux in male and female infants with pre-natal hydronephrosis. Br J Urol. 1997;80(2):319e27.

The Evaluation of Postnatal Follow-up Results of the İnfants with Mild and Moderate İsolated Antenatal Hydronephrosis

Yıl 2019, Cilt: 41 Sayı: 1, 17 - 22, 01.01.2019
https://doi.org/10.20515/otd.425849

Öz

Antenatal hydronephrosis is
one of the most common congenital urological anomalies identified on
 prenatal ultrasound. There
are
controversial results in the postnatal management of mild-moderate isolated antenatal hydronephrosis. The
purpose of this study was to investigate the
clinical outcome and the frequency
of urinary tract infection in infants with mild-moderate
isolated antenatal hydronephrosis
during the first year of life.
The patients with mild-moderate hydronephrosis on the first renal
ultrasonography done between seven days and two weeks of age were included in
this study. The patients with other kidney abnormalities other than
hydronephrosis, ureteral dilatation or bladder abnormalities were not included
in the study. Hydronephrosis was classified as mild (5-9.9 mm), moderate
(10-14.9 mm) by anterior-posterior pelvic diameters.  140 patients [96 boys (68.6%), 44 girls
(31.4%)] were included in the study. Sixty (42.9%) patients had mild
hydronephrosis and 80 (57.1%) patients had moderate hydronephrosis. The rate of
spontan resolution was higher in patients with mild hydronephrosis than other
group [n=58 (96.6%), n=48 (60%), respectively, p<0.01]. The median
regression time was shorter in patients with mild hydronephrosis [median
regression time; 4 (3-5.25); 6 (5-7) months, respectively,  p<0.01]. The frequency of urinary tract
infection did not differ between the patients with mild and moderate
hydronephrosis patients (p>0.05). There was no evidence of acute
pyelonephritis and obstructive or progressive hydronephrosis. Mild and moderate
isolated antenatal hydronephrosis is often a self-limited condition. Children
with mild and moderate isolated antenatal hydronephrosis might be followed
without antibiotic prophylaxis.

Kaynakça

  • Referans1 Bozacı AC, Doğan HS, Tekgül S. Antenatal Hidronefroz. Turkiye Klinikleri J Urology-Special Topics 2015;8(4):7-13.
  • Referans2 Lee RS, Cendron M, Kinnamon DD, Nguyen H T. Antenatal hydronephrosis as a predictor of postnatal outcome: A meta-analysis. Pediatrics. 2006;118 (2): 586–93.
  • Referans3 Sidhu G, Beyene J, Rosenblum ND. Outcome of isolated antenatal hydronephrosis: a systematic review and metaanalysis. Pediatr Nephrol. 2006; 21(2): 218e24.
  • Referans4 Homsy YL, Saad F, Laberge I, Williot P, Pison C. Transitional hydronephrosis of the newborn and infant. J Urol. 1990;144(2 Pt 2):579e83.
  • Referans5 Ismaili K, Avni FE, Piepsz A, Wissing KM, Cochat P, Aubert D, et al. Current management of infants with fetal renal pelvis dilation: a survey by French-speaking pediatric nephrologists and urologists. Pediatr Nephrol. 2004;19(9):966–971.
  • Referans6 Shaikh N, Ewing AL, Bhatnagar S, Hoberman A. Risk of renal scarring in children with a first urinary tract infection: a systematic review. Pediatrics. 2010;126(6):1084-91.
  • Referans7 Williams GJ, Wei L, Lee A, Craig JC. Long-term antibiotics for preventing recurrent urinary tract infection in children. Cochrane Database Syst Rev. 2006;19(3):CD001534.
  • Referans8 Blachar A, Blachar Y, Livne PM, Zurkowski L, Pelet D, Mogilner B. Clinical outcome and follow-up of prenatal hydronephrosis. Pediatr Nephrol. 1994;8(1):30–35.
  • Referans9 Al-Shibli AI, Chedid F, Mirghani H, Al Safi W, Al-Bassam MK. The significance of fetal renal pelvic dilatation as a predictor of postnatal outcome. J Matern Fetal Neonatal Med. 2009; 22(9):797e800.
  • Referans10 Asl AS, Maleknejad S. Clinical outcome and follow-up of prenatal hydronephrosis. Saudi J Kidney Dis Transpl. 2012;23(3):526e31.
  • Referans11 Bak M, Tümay D, Serdaroğlu E. The postnatsl follow-up prenatally diagnosed diagnosed urinary anomalies cases. Turkiye Klinikleri J Pediatr 2007;16(4):255-63.
  • Referans12 Mami C, Paolata A, Palmara A, Marrone T, Berte LF, Marseglia L, et al. Outcome and management of isolated moderate renal pelvis dilatation detected at postnatal screening. Pediatr Nephrol. 2009;24(10):2005–2008.
  • Referans13 Sairam S, Al-Habib A, Sasson S, Thilaganathan B. Natural history of fetal hydronephrosis diagnosed on mid-trimester ultrasound. Ultrasound Obstet Gynecol. 2001;17(3):191–196.
  • Referans14 Mallik M, Watson AR. Antenatally detected urinary tract abnormalities: more detection but less action. Pediatr Nephrol. 2008;23(6):897–904.
  • Referans15 Tekin M, Gülyüz A, Özay C, Konca Ç. Postnatal Assessment and Outcome of Infants with Antenatal Hydronephrosis. Turkish J Pediatr Dis. 2016;2:96-100.
  • Referans16 Çamlar SA, Deveci N, Soylu A, Türkmen MA, Özmen D, Çapakaya G, et al. The role of dynamic renal scintigraphy on clinical decision making in hydronephrotic children. Saudi J Kidney Dis Transpl. 2017;28(1):76-80.
  • Referans17 Brenner DJ, Hall EJ. Computed tomography-An increasing source of radiation exposure. N Engl J Med. 2007;357(22):2277-84.
  • Referans18 Smith T, Gordon I. An update of radiopharmaceutical schedules in children. Nucl Med Communicat. 1998;19(11):1023-36.
  • Referans19 Easterbrook B, Capolicchio JP, Braga LH. Antibiotic prophylaxis for prevention of urinary tract infections in prenatal hydronephrosis: An updated systematic review. Can Urol Assoc J. 2017;11(1-2Suppl1): S3-11.
  • Referans20 Montini G, Tullus K, Hewitt I. Febrile urinary tract infections in children. N Engl J Med. 2011;365(3):239-50.
  • Referans21 Walsh TJ, Hsieh S, Grady R, Mueller BA. Antenatal hydronephrosis and the risk of pyelonephritis hospitalization during the first year of life. Urology 2007;69(5):970-4.
  • Referans22 Woodward M, Frank D. Postnatal management of antenatal hydronephrosis. BJU Int. 2002;89(2):149–156.
  • Referans23 Roth CC, Hubanks JM, Bright BC, Heinlen JE, Donovan BO, Kropp BP, et al. Occurrence of urinary tract infection in children with significant upper urinary tract obstruction. Urology 2009;73(1):74–78.
  • Referans24 Alconcher L, Tombesi M. Mild antenatal hydronephrosis: management controversies. Pediatr Nephrol. 2004;19(7):819–820.
  • Referans25 Lidefelt KJ, Herthelius M. Antenatal hydronephrosis: infants with minor postnatal dilatation do not need prophylaxis. Pediatr Nephrol. 2008;23(11):2021–2024.
  • Referans26 Braga LH, Mijovic H, Farrokhyar F, Pemberton J, DeMaria J, Lorenzo AJ. Antibiotic prophylaxis for urinary tract infections in antenatal hydronephrosis. Pediatrics 2013;131(1):e251.
  • Referans27 Elder JS. Commentary: importance of antenatal diagnosis of vesicoureteral reflux. J Urol. 1992(5 Pt 2);148:1750e4.
  • Referans28 Andrich M, Massoud M. Diagnostic imaging in the evaluation of first time urinary tract infection in infants and young children. Pediatrics 1992;90(3):436–41.
  • Referans29 Passerotti CC, Kalish LA, Chow J, Passerotti AM, Recabal P, Cendron M, et al. The predictive value of the first postnatal ultrasound in children with antenatal hydronephrosis. J Pediatr Urol. 2011;7(2):128-36.
  • Referans30 Yeung CK, Godley ML, Dhillon HK, Gordon I, Duffy PG, Ransley PG. The characteristics of primary vesico-ureteric reflux in male and female infants with pre-natal hydronephrosis. Br J Urol. 1997;80(2):319e27.
Toplam 30 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm ORİJİNAL MAKALELER / ORIGINAL ARTICLES
Yazarlar

Nuran Çetin 0000-0001-5763-9815

Yayımlanma Tarihi 1 Ocak 2019
Yayımlandığı Sayı Yıl 2019 Cilt: 41 Sayı: 1

Kaynak Göster

Vancouver Çetin N. The Evaluation of Postnatal Follow-up Results of the İnfants with Mild and Moderate İsolated Antenatal Hydronephrosis. Osmangazi Tıp Dergisi. 2019;41(1):17-22.


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