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Neonates with extra-renal pelvis: the first 2 years.
Ze'ev Katzir1, Michaela Witzling, Gallina Nikolov
1Institute of Nephrology, E. Wolfson Medical Center, Holon, Israel. Katzir@wolfson.health.gov.il
Pediatric Nephrology (Berlin, Germany)
|April 20, 2005
Summary
Extra-renal pelvis (ERpel) in neonates is linked to higher rates of congenital malformations and urinary tract infections (UTIs). However, ERpel often resolves within two years without causing kidney function decline.
Area of Science:
- Pediatric Nephrology
- Neonatal Imaging
- Congenital Anomalies
Background:
- Extra-renal pelvis (ERpel) is a common finding in neonates with prenatal renal pelvic dilatation.
- Its prognostic implications require further investigation.
Purpose of the Study:
- To determine the prognostic significance of ERpel in neonates.
- To assess the association of ERpel with congenital malformations, vesico-ureteral reflux (VU reflux), and urinary tract infections (UTIs).
Main Methods:
- Seventy-nine neonates with prenatal renal pelvic dilatation diagnosed with ERpel were studied.
- Postnatal evaluation included Tc-99m DPTA renal scans, cystography, clinical assessment, urine cultures, and 2-year follow-up ultrasounds.
- UTI incidence was compared to a control group with normal scans.
Main Results:
- ERpel was more frequent in males and associated with minor congenital malformations (15.2%) and VU reflux (15%).
- The incidence of UTI in the ERpel group (20.2%) was significantly higher than in controls (1.2-4.3%).
- Within 2 years, 41.5% of ERpel cases resolved, 22.6% showed improvement, and 1.8% developed hydronephrosis; no kidney function deterioration was observed.
Conclusions:
- Neonatal ERpel is associated with increased risks of congenital anomalies, VU reflux, and UTIs compared to the general population.
- The elevated UTI incidence in ERpel is not solely attributed to VU reflux.
- ERpel generally has a favorable prognosis with a high resolution rate and no observed long-term kidney damage.