Abstract
MP72-17 THE UTILITY OF RENAL SONOGRAPHIC MEASUREMENTS IN DIFFERENTIATING CHILDREN WITH GRADES 2, 3, AND 4 HYDRONEPHROSIS
The Journal of urology, Vol.211(5S), p.e1178
05/2024
DOI: 10.1097/01.JU.0001009572.60675.69.17
Abstract
INTRODUCTION AND OBJECTIVE:
Prior analysis of children with congenital hydronephrosis demonstrated that renal medullary pyramidal thickness (PT) alone was predictive of subsequent pyeloplasty (AUC=0.78) and a novel pyeloplasty predictive score (PPS) using only objective sonographic measurements had an AUC of 0.88. The objective of this study was a further analysis of the utility of sonographic measurements with a 50% expansion of the number of children with hydronephrotic kidneys now including grades 2, 3, and 4 hydronephrosis.
METHODS:
A retrospective review was performed of 166 children (188 hydronephrotic kidneys), out of which 144 had unilateral hydronephrosis and 22 had bilateral hydronephrosis. 109 kidneys were observed and 79 underwent pyeloplasty. Indications for surgery included an obstructive drainage pattern with a T1/2 >20 min on diuretic renal scan in addition to decreased relative renal function less than 40%, increasing hydronephrosis on serial ultrasounds, and/or a decline in relative renal function >10% on serial renal scans. The PT, APD, and renal length were measured on sonographic images. Receiver operating characteristic (ROC) curves were generated for inclusive multivariate models for prediction of pyeloplasty with and without SFU grade.
RESULTS:
The AUC of the ROC constructed solely using PT to predict pyeloplasty was 0.821. A PT cutoff of 3 mm would identify 72% of kidneys requiring pyeloplasty and accurately exclude 81% of those not needing the procedure. Significant factors associated with pyeloplasty from logistic regression modeling identified PT <3mm, APD, SFU grade, and female gender. The ROC curves of the predictive performance of multivariate predictive models with and without SFU grade demonstrated an AUC of 0.901 and 0.868, respectively.
CONCLUSIONS:
These results further support the finding that PT is a reliable and useful measurement to characterize the hydronephrotic kidney parenchyma and that a PT <3 mm is a useful criterion for ‘thinned parenchyma’ which could be used to differentiate kidneys in the SFU, UTD, and other hydronephrosis grading systems. A PPS using only objective measurements including PT, APD, and renal length was almost as accurate as a PPS that incorporated SFU grade and may offer the advantage of being more objective and reliable.
Details
- Title: Subtitle
- MP72-17 THE UTILITY OF RENAL SONOGRAPHIC MEASUREMENTS IN DIFFERENTIATING CHILDREN WITH GRADES 2, 3, AND 4 HYDRONEPHROSIS
- Creators
- Christopher S. CooperTomas LenceHanh T. D. PhamCaitlin E. WardGina M. LockwoodDouglas W. Storm
- Resource Type
- Abstract
- Publication Details
- The Journal of urology, Vol.211(5S), p.e1178
- DOI
- 10.1097/01.JU.0001009572.60675.69.17
- ISSN
- 0022-5347
- eISSN
- 1527-3792
- Language
- English
- Date published
- 05/2024
- Academic Unit
- Nursing; Urology; Medicine Administration; Stead Family Department of Pediatrics
- Record Identifier
- 9984643652702771
Metrics
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