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Does antenatal pelvic dilation predict renal scarring?

N D Plant1, R J Hornung, M G Coulthard

  • 1Department of Paediatric Nephrology, Royal Victoria Infirmary, Newcastle, UK. nick.plant@cmmc.nhs.uk

Archives of Disease in Childhood. Fetal and Neonatal Edition
|July 23, 2005
PubMed

Insights

Moderate antenatal renal pelvic dilation in children does not appear to predict kidney scarring. Current investigations and treatments for this condition may not be necessary, simplifying pediatric urological care.

Area of Science:

  • Pediatric Urology
  • Diagnostic Imaging
  • Nephrology

Background:

  • Antenatal renal pelvic dilation (RPD) is a common finding in prenatal ultrasounds.
  • Moderate RPD (5-15 mm) can be associated with vesicoureteric reflux (VUR).
  • The predictive value of moderate RPD for renal scarring remains unclear.

Purpose of the Study:

  • To evaluate the association between moderate antenatal RPD and renal scarring in children.
  • To determine if current investigation and treatment protocols for moderate RPD are warranted.

Main Methods:

  • Retrospective analysis of children with moderate antenatal RPD.
  • Dimercaptosuccinic acid (DMSA) scintigraphy performed in children over 4 years of age.
  • Comparison of scarring rates with local population data.

Main Results:

  • Low incidence of renal scarring observed in children with moderate RPD.
  • Scarring rate in boys was 0/133, and in girls was 1/56.
  • These rates were similar to the general population.

Conclusions:

  • Moderate antenatal RPD is not a reliable predictor of renal scarring.
  • Routine investigation and treatment for moderate RPD may be unnecessary.
  • This finding could lead to reduced medical interventions in pediatric urology.

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