Outcomes of Children with Antenatal Hydronephrosis Admıtted to Our Polyclinic; The Significance of Pathological Hydronephrosis and Impact of Severe Antenatal Hydronephrosis on Prognosis

Year 2016, Volume: 18 Issue: 2, 60 - 65, 01.07.2016

Nurver Akıncı Önder Kılıçaslan

Abstract

Antenatal hydronephrosis is the most common renal abnormalities detected during pregnancyand the extensive use of ultrasonography during pregnancy has resulted in a greater detectionrate for antenatal hydronephrosis. The objective of our study is to investigate etiology of patientsthat were diagnosed antenatal hydronephrosis, to emphasize the significance of pathologicalhydronephrosis, to investigate the relationship between hydronephrosis scores and urinarysystem anomalies and contribute to the literature. Patients, admitted to pediatric nephrologypolyclinic between October 2008 and February 2013, were investigated retrospectively; 85patients and 124 kidneys were taken into study. The majority of patients were boys. 36.5% ofthe patients were first diagnosed on 2nd trimester, and 63.5 % were first diagnosed on the 3rdtrimester. 73.9% of the patients had antenatal hydronephrosis on their left kidney. Urinaryinfection rate in all the patients was 18.8%, and it was significantly high in patients withpathologic hydronephrosis. Detection of pathologic hydronephrosis by ultrasonography wassignificantly higher in patients with severe hydronephrosis. During their follow-up 12.9% ofthe patients underwent surgery. Surgery rate was significantly higher in patients with pathologichydronephrosis. The majority of patients with antenatal hydronephrosis are found to have nonpathological hydronephrosis in their follow-up. Diagnosing severe and pathologichydronephrosis is important for follow-up and treatment strategies

Keywords

antenatal hydronephrosis, prenatal diagnosis, hydronephrosis follow-up

POLİKLİNİĞİMİZE BAŞVURAN ANTENATAL HİDRONEFROZ TANILI ÇOCUKLARIN TAKİP SONUÇLARI; PATOLOJİK HİDRONEFROZUN ÖNEMİ VE AĞIR DERECE ANTENATAL HİDRONEFROZUN PROGNOZA ETKİSİ

Abstract

Antenatal hidronefroz en sık belirlenen genitoüriner sistem anomalisidir ve tanı sıklığıultrasonografinin yaygın kullanımı sonrası artmıştır. Bu çalışmada amacımız antenatalhidronefroz tanısı alan hastalarda etiyolojik nedenleri ortaya koymak, patolojik hidronefrozunönemini vurgulamak, hidronefroz dereceleri ile üriner sistem anomalileri arasındaki ilişkiyiirdelemek ve literatüre katkıda bulunmaktır. Ekim 2008 ve Şubat 2013 tarihleri arasında çocuknefroloji polikliniğine başvuran 85 hasta ve 124 böbrek geriye yönelik değerlendirildi.Hastaların; çoğu erkekti,%36,5’i 2. trimesterde, %63,5’i 3. trimesterde tanı almıştı. Hastaların%73,9’nda sol böbrekte antenatal hidronefroz mevcuttu. Tüm hastalarda idrar yolu enfeksiyonugeçirme oranı %18,8 olarak saptandı, patolojik hidronefrozlu hastalarda anlamlı derecede yükseksaptandı. Yapılan USG'lerde ağır derecede hidronefroz saptanan hastalarda patolojik hidronefrozsaptanma oranı anlamlı olarak yüksekti. Takip süresi boyunca hastaların %12,9’u operasyongeçirdi. Patolojik hidronefrozlu hastalarda operasyon geçirme oranı anlamlı derecede yükseksaptandı. Antenatal hidronefroz tanılı hastaların takipleri sonucunda büyük çoğunluğu patolojikolmayan hidronefroz tespit edilmektedir. Ağır derece ve patolojik hidronefrozların saptanmasıtakip ve tedavi açısından önemlidir

Keywords

antenatal hidronefroz, prenatal tanı, hidronefroz takibi

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