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An initial differential renal function between 35% and 40% has greater probability of leading to normal after pyeloplasty in patients with unilateral pelvic-ureteric junction obstruction

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Abstract

Purpose

We compared the outcomes in patients who were <1 year old and had hydronephrosis with SFU grade 3–4 PUJ obstruction to observe the potential recovery of renal morphology and DRF after successful pyeloplasty.

Methods

All children younger than 1 year old with SFU grade 3–4 PUJ obstruction from January 2013 to June 2015 were retrospectively analyzed. A total of 92 children were grouped according to their DRF value at pyeloplasty as follows: DRF from 30 to ≤35% (group I) and DRF from 35 to ≤40% (group II). We evaluated changes in anteroposterior diameter and differential renal function using ultrasound and diuretic renography. Outcomes were compared using Student t test.

Results

Group I comprised 45 patients, and group II included 47 patients. No significant difference was observed in the initial APD, final APD and the improvement of APD after pyeloplasty between two groups. Significant differences were observed between the initial and final DRF values in both groups. The difference in DRF improvement after pyeloplasty between groups I and II was significant. The DRF improved to a normal stage significantly more frequently in group II (21/47; 44.7%) than in group I (13/45; 28.9%).

Conclusion

The improvement in DRF after pyeloplasty was significant for patients with an initial DRF from 30 to ≤35%. However, patients with an initial DRF from 35 to ≤40% had a greater probability of achieving normal renal function. Patients with severely impaired initial renal function had a marginal probability of achieving a normal value.

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Acknowledgements

This work was supported by grants from The National Nature Sciences Foundation of China (No. 81672488), Science and Technology Commission of Shanghai Municipality 14411950408, 14411950400, 14411950403, and Shanghai Municipal Education Commission—Gaofeng Clinical Medicine Grant.

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Authors and Affiliations

  1. Department of Pediatric Urology, Xinhua Hospital, National Key Clinical Specialty, Shanghai Top-Priority Clinical Center, Shanghai Jiao Tong University School of Medicine, 1665 Kongjiang St., Shanghai, 200092, China

    Guofeng Xu, Maosheng Xu, Zhoutong Chen, Dapeng Jiang, Houwei Lin, Xiaoliang Fang, Liguo Wang, Lei He & Hongquan Geng

  2. Children Hospital of Kaifeng City, Kaifeng, Henan Province, China

    Jianqi Ma

  3. Jiaxing Maternity and Child Health Care Hospital, Jiaxing, Zhejiang Province, China

    Zhihua Hong

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  1. Guofeng Xu
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  2. Maosheng Xu
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  3. Jianqi Ma
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  4. Zhoutong Chen
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  5. Dapeng Jiang
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  6. Zhihua Hong
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  7. Houwei Lin
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  8. Xiaoliang Fang
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  9. Liguo Wang
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  10. Lei He
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  11. Hongquan Geng
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Corresponding author

Correspondence to Hongquan Geng.

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The authors declare that they have no conflict of interest.

Ethical standards

The study is approved by the ethics committee of Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine. This article contains no personal information of any patients enrolled.

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Xu, G., Xu, M., Ma, J. et al. An initial differential renal function between 35% and 40% has greater probability of leading to normal after pyeloplasty in patients with unilateral pelvic-ureteric junction obstruction. Int Urol Nephrol 49, 1701–1706 (2017). https://doi.org/10.1007/s11255-017-1665-0

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  • DOI: https://doi.org/10.1007/s11255-017-1665-0

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