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Factors indicating renal injury in pediatric bilateral ureteropelvic- junction obstruction

Authors
 Yong Seung Lee  ;  Hyeon Joo Jeong  ;  Young Jae Im  ;  Myung-Joon Kim  ;  Mi-Jung Lee  ;  Mijin Yun  ;  Sang Won Han 
Citation
 UROLOGY, Vol.81(4) : 873-878, 2013 
Journal Title
 UROLOGY 
ISSN
 0090-4295 
Issue Date
2013
MeSH
Female ; Humans ; Hydronephrosis/pathology ; Infant ; Kidney/pathology ; Kidney Diseases/diagnosis* ; Kidney Diseases/pathology ; Kidney Pelvis*/pathology ; Male ; Retrospective Studies ; Ureteral Obstruction/diagnosis* ; Ureteral Obstruction/surgery
Keywords
Female ; Humans ; Hydronephrosis/pathology ; Infant ; Kidney/pathology ; Kidney Diseases/diagnosis* ; Kidney Diseases/pathology ; Kidney Pelvis*/pathology ; Male ; Retrospective Studies ; Ureteral Obstruction/diagnosis* ; Ureteral Obstruction/surgery
Abstract
OBJECTIVE: To analyze the factors indicating renal injury in patients with bilateral ureteropelvic-junction obstruction (UPJO). METHODS: We investigated 26 patients, 35 kidney units (KUs), who were diagnosed with bilateral UPJO and underwent unilateral or bilateral pyeloplasty between January 2000 and December 2011. During pyeloplasty, ipsilateral kidney biopsy was performed. Kidney biopsy results were divided into 3 categories. Hydronephrosis was analyzed using both the Society of Fetal Urology (SFU) and Onen's grading system. We investigated factors related with the renal histopathologic results of 29 KUs. We additionally analyzed whether there were factors predicting contralateral pyeloplasty after initial unilateral pyeloplasty. RESULTS: Ten KUs (34.5%) showed grade 1 histopathologic change, whereas 10 KUs (34.5%) and 9 KUs (31.0%) showed grade 2 and 3 change, respectively. Preoperative differential renal function (DRF) and serum creatinine levels were not different among groups (P = .697 and .516, respectively). Hydronephrosis grade was not different when graded by SFU system (P = .100) while significantly different by Onen's system (P <.001). Among 23 patients with initial unilateral pyeloplasty, additional contralateral pyeloplasty was required in 6 patients (26.1%). There were no significant preoperative factors predicting the need for additional operations. CONCLUSION: In bilateral UPJO, DRF, and SFU grade of hydronephrosis did not correctly reflect renal injury. Onen's hydronephrosis grade showed a significant relationship with renal histopathologic grade and could be an indicator for renal injury in bilateral UPJO.
Full Text
http://www.sciencedirect.com/science/article/pii/S009042951201480X
DOI
10.1016/j.urology.2012.09.064
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Nuclear Medicine (핵의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
Yonsei Authors
Kim, Myung Joon(김명준) ORCID logo https://orcid.org/0000-0002-4608-0275
Yun, Mi Jin(윤미진) ORCID logo https://orcid.org/0000-0002-1712-163X
Lee, Mi-Jung(이미정) ORCID logo https://orcid.org/0000-0003-3244-9171
Lee, Yong Seung(이용승) ORCID logo https://orcid.org/0000-0003-3778-9888
Im, Young Jae(임영재)
Jeong, Hyeon Joo(정현주) ORCID logo https://orcid.org/0000-0002-9695-1227
Han, Sang Won(한상원) ORCID logo https://orcid.org/0000-0003-0941-1300
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/86942
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