Development of pediatric hydronephrosis patients visiting the San Vicente Foundation University Hospital, Medellin, Colombia

• Published in: Iatreia (Medellín, Colombia) Vol. 27; no. 2; p. 147
• Main Authors: Velez-Tejada, Paulina, Nino-Serna, Laura, Serna-Higuita, Lina Maria, Serrano-Gayubo, Ana Katherina, Velez-Echeverri, Catalina, Vanegas-Ruiz, Juan Jose, Abaunza, Javier Mauricio Sierra, Piedrahita-Echeverry, Vilma
• Format: Journal Article
• Language: Spanish
• Published: Medellín Universidad de Antioquia, Facultad de Medicina 01.04.2014; Universidad de Antioquía
• Subjects: Birth defects; Child health; Chronic kidney failure; Genetic disorders; Health aspects; Hydronephrosis; Pregnant women; Ultrasound imaging
• ISSN: 0121-0793; 2011-7965

Hydronephrosis is one of the most common congenital malformations detected on prenatal ultrasounds. Moderate and severe cases are often associated with urological abnormality. OBJECTIVE To describe a series of pediatric patients diagnosed with hydronephrosis determining their etiology, prenatal diagnosis and frequency of chronic kidney disease (CKD). MATERIALS AND METHODS A descriptive, retrospective study. RESULTS The records of 924 patients between the ages of 0 and 18 years were evaluated, 35.7% female and 64.3% male. In 14.4% (133) the diagnosis was prenatal. Hydronephrosis was bilateral in 198 patients (28.5%). In 18.3% (169) no associated urological abnormality was found, reaching 4.2% in CKD (7). Ureteropelvic stenosis was diagnosed in 23.3% (216) followed with 21.5% VUR (199) and posterior urethral valves in 9.4% (87), reaching 10.2% ERC (93). When the hydroneprhosis was diagnosed by urography those patients presented 11.3% of chronic kidney disease vs. 8.4% in whom the diagnosis was made by ultrasound, when the hydronephosis diagnosed was by prenatal vs postnatal ultrasound, the percentage of CKD was 4.8% vs 10.8%, respectively. CONCLUSION Early diagnosis of hydronephrosis allows the detection of urologic abnormalities susceptible of treatment. Although there are still many questions about which one is the ideal strategy of follow up; the ultrasonography voiding cystourethrogram, urography scintigraphy and magnetic resonance urography in selected patients are the most useful tools in order to evaluate urinary tract anomaly. KEYWORDS Hydronephrosis, Prenatal Diagnosis, Ultrasonography, Vesico-Ureteral Reflux, Ureteral Obstruction.