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Unilateral Ureteral Obstruction Model for Investigating Kidney Interstitial Fibrosis
04:37

Unilateral Ureteral Obstruction Model for Investigating Kidney Interstitial Fibrosis

Published on: April 25, 2025

Unilateral ureteropelvic junction obstruction in children: long-term followup after unilateral pyeloplasty

Ariane Boubaker1, John O Prior, Blaise Meyrat

  • 1Nuclear Medicine Department, University Hospital, Lausanne, Switzerland.

The Journal of Urology
|July 11, 2003
PubMed

Insights

Surgery for unilateral ureteropelvic junction stenosis (UPJS) in children can preserve kidney function. Post-pyeloplasty renography shows improved or normalized function in many cases, though some kidneys require long-term monitoring.

Area of Science:

  • Pediatric Urology
  • Nephrology
  • Radiology

Background:

  • Unilateral ureteropelvic junction stenosis (UPJS) is a common congenital anomaly.
  • The long-term impact of pyeloplasty on renal function in pediatric UPJS remains a subject of debate.

Purpose of the Study:

  • To evaluate the renal function outcome after unilateral pyeloplasty in children with UPJS.
  • To assess the utility of 123I-hippuran renography in determining renal function post-pyeloplasty.

Main Methods:

  • Retrospective review of 53 children who underwent successful pyeloplasty for unilateral UPJS.
  • Analysis of 123I-hippuran renography data obtained at diagnosis and 5–15 years post-surgery.
  • Measurement of relative function (RF) and absolute function using an accumulation index (AI).

Main Results:

  • Preoperatively, 33 of 53 UPJS kidneys showed decreased AI, but only 8 had RF < 40%.
  • Post-pyeloplasty, AI improved in 29 kidneys (19 normalized), while 14 had persistently abnormal AI.
  • Contralateral kidney function often compensated for impaired UPJS kidney function, with AI decreasing from supranormal to normal in some cases.

Conclusions:

  • 123I-hippuran renography, particularly AI, provides valuable insights into renal function post-pyeloplasty for UPJS.
  • AI effectively identifies compensatory changes in the contralateral kidney in cases of impaired UPJS kidney function.
  • Normal AI and RF correlate well in predicting favorable long-term renal function outcomes.
Abstract

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