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Diagnostic accuracy of postnatal renal pelvic diameter as a predictor of uropathy: a prospective study

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Abstract

Background: There is a necessity to standardize postnatal ultrasonographic markers predictive of significant uropathies. The purpose of this study was to assess the accuracy of anteroposterior renal pelvic diameter (APD) on postnatal ultrasound to discriminate between significant uropathy and idiopathic renal pelvic dilatation. Materials and methods: Neonates (n=110) who were found to have isolated fetal renal pelvic dilatation underwent systematic investigation and were prospectively followed up. A US scan was performed after the 1st week of life, and all infants underwent voiding cystourethrography. Neonates with an APD larger than 10 mm were examined with renal scintigraphy. Receiver-operating characteristic (ROC) plots were constructed to determine the best cutoffs for APD to identify renal units with significant uropathy as well as those requiring surgical intervention. Results: The area under the curve (AUC) estimated by the ROC curve was 0.921 (95% CI=0.869–0.957), indicating excellent discriminant power between nonsignificant pelvis dilatation and significant uropathy. A cutoff of 10 mm for APD showed the best accuracy for identifying infants with a significant uropathy (sensitivity, 90.4%; specificity, 91%). To identify infants who required surgical intervention, the calculated AUC was 0.976 (95% CI=0.940–0.993). A cutoff of 15 mm showed the best diagnostic performance for identifying the renal units requiring pyeloplasty (sensitivity, 100%; specificity, 92.5%). Conclusion: Our results suggest that postnatal APD is an excellent test for identifying fetuses with significant uropathy, as well as those requiring postnatal intervention.

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Acknowledgments

This study was partly supported by Conselho de Desenvolvimento Científico e Tecnológico (CNPq), FAPEMIG, and Pró-Reitoria de Pesquisa-UFMG.

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Authors and Affiliations

  1. Neonatal Unit, Department of Pediatrics, Hospital das Clínicas, Federal University of Minas Gerais, Avenida Professor Alfredo Balena 190, Belo Horizonte, 30130-100, Brazil

    Maria Cândida Ferrarez Bouzada

  2. Pediatric Nephrourology Unit, Department of Pediatrics, Hospital das Clínicas, Federal University of Minas Gerais, Avenida Professor Alfredo Balena 190, Belo Horizonte, 30130-100, Brazil

    Eduardo Araujo Oliveira

  3. Ultrasound Unit, CNPq Researcher, Hospital das Clínicas, Federal University of Minas Gerais, Avenida Professor Alfredo Balena 190, Belo Horizonte, 30130-100, Brazil

    Eduardo Araujo Oliveira

  4. Fetal Medicine Unit, Department of Gynecology and Obstetrics, Hospital das Clínicas, Federal University of Minas Gerais, Avenida Professor Alfredo Balena 190, Belo Horizonte, 30130-100, Brazil

    Alamanda Kfoury Pereira & Henrique Vitor Leite

  5. FAPEMIG and CNPq studentship, Hospital das Clínicas, Federal University of Minas Gerais, Avenida Professor Alfredo Balena 190, Belo Horizonte, 30130-100, Brazil

    Andréia Moura Rodrigues, Lívia Alvarenga Fagundes, Ricardo Peixoto Gonçalves & Ricardo Parreiras

  6. Rua Patagonia 515 / 701, 30320-080, Belo Horizonte, Minas Gerais, Brazil

    Eduardo Araujo Oliveira

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  1. Maria Cândida Ferrarez Bouzada
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  2. Eduardo Araujo Oliveira
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  3. Alamanda Kfoury Pereira
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  4. Henrique Vitor Leite
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  5. Andréia Moura Rodrigues
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  7. Ricardo Peixoto Gonçalves
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  8. Ricardo Parreiras
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Correspondence to Eduardo Araujo Oliveira.

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Bouzada, M.C.F., Oliveira, E.A., Pereira, A.K. et al. Diagnostic accuracy of postnatal renal pelvic diameter as a predictor of uropathy: a prospective study. Pediatr Radiol 34, 798–804 (2004). https://doi.org/10.1007/s00247-004-1283-8

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  • DOI: https://doi.org/10.1007/s00247-004-1283-8

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