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Utilization of Radiographic Imaging for Infant Hydronephrosis over the First 12 Months of Life

Anthony J Schaeffer1, Patrick C Cartwright1, Glen A Lau1

  • 1Division of Urology, Department of Surgery, University of Utah, Salt Lake City, UT, USA.

Advances in Urology
|August 18, 2020
PubMed

Insights

Imaging use for infant hydronephrosis (HN) is directly related to its initial severity. This study suggests a risk-stratified approach to imaging for HN in infants, with more severe cases receiving more frequent imaging studies.

Area of Science:

  • Pediatric Urology
  • Radiology
  • Healthcare Management

Background:

  • Infant hydronephrosis (HN) management varies, potentially influenced by imaging intensity based on HN grade.
  • A standardized approach to workup and surveillance is needed for optimal patient outcomes.

Purpose of the Study:

  • To determine the frequency of imaging studies for infant hydronephrosis within the first year of life.
  • To stratify imaging use by the initial grade of hydronephrosis in a large healthcare system.

Main Methods:

  • Retrospective cohort study of infants born between 2005-2013 with confirmed hydronephrosis.
  • Data collected included initial hydronephrosis grade, demographic information, and all HN-associated radiologic studies (ultrasound, VCUG, diuretic renal scans).
  • Multivariate Poisson regression analyzed the association between initial HN grade and the total number of imaging studies within the first year or prior to pyeloplasty.

Main Results:

  • Out of 1,380 infants, 72% had mild, 17% moderate, and 12% severe hydronephrosis.
  • Infants with moderate and severe HN showed significantly higher rates of imaging use compared to those with mild HN (RR 1.57 and 2.09, respectively).
  • Imaging frequency was proportional to the initial hydronephrosis grade after controlling for confounders.

Conclusions:

  • Imaging utilization for infant hydronephrosis in this healthcare system is directly proportional to the initial grade of HN.
  • This finding supports the use of a risk-stratified approach in managing infant hydronephrosis surveillance and workup.
  • The study highlights a consistent, grade-dependent imaging strategy for pediatric hydronephrosis.
Abstract

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