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Point-of-Care Kidney and Genitourinary Ultrasound in Adults: Image Acquisition

Point-of-Care Kidney and Genitourinary Ultrasound in Adults: Image Acquisition

Published on: June 21, 2024

Mild to moderate postnatal hydronephrosis--grading systems and management.

Matthew D Timberlake¹, C D Anthony Herndon

¹Division of Pediatric Urology, Department of Urology, University of Virginia, PO Box 800422, Charlottesville, VA 22908-0422, USA.

Nature Reviews. Urology

|August 21, 2013

Summary

Management guidelines for mild to moderate antenatal hydronephrosis (ANH) are lacking, leading to varied clinical practices. This study proposes a risk stratification approach for postnatal evaluation and management of ANH to identify at-risk infants.

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Area of Science:

Pediatric Urology
Fetal Medicine
Radiology

Background:

No universal guidelines exist for managing mild to moderate antenatal hydronephrosis (ANH).
Clinical practice patterns for postnatal evaluation and imaging vary significantly.
Existing grading tools for ANH and postnatal hydronephrosis are often used interchangeably, impacting their effectiveness.

Purpose of the Study:

To highlight the need for a universal classification system and nomenclature for ANH.
To present a novel approach for postnatal risk stratification and management of ANH.
To identify infants at risk of renal deterioration, urinary tract infections (UTI), and surgical intervention.

Main Methods:

Development of a risk stratification protocol for postnatal ANH management.
Recommendations for serial ultrasonography schedules.
Guidelines for prophylactic antibiotics, voiding cystourethrogram (VCUG), and renal scintigraphy.

Main Results:

The proposed approach facilitates standardized postnatal risk stratification.
The protocol aims to optimize follow-up imaging and interventions.
Enables better identification of infants requiring surgical consultation.

Conclusions:

A standardized approach to ANH management is crucial.
The presented risk stratification aids in identifying infants needing closer monitoring and intervention.
This strategy can potentially reduce complications and unnecessary procedures in ANH cases.