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Pyeloplasty in children with low differential renal function: Functional recoverability
Osama Sarhan1, Abdulhakim Al Otay2, Abdulmohsin Al Faddagh3
1Urology and Nephrology Center, Faculty of Medicine, Mansoura University, Mansoura, Egypt; Urology Department, King Fahad Specialist Hospital, Dammam, Saudi Arabia.
Journal of Pediatric Urology
|July 27, 2021
Summary
Pyeloplasty offers favorable outcomes for children with ureteropelvic junction obstruction (UPJO) and low differential renal function (DRF) ≤20%. Postoperative improvement in hydronephrosis on renal ultrasound indicates successful surgical intervention.
Area of Science:
- Pediatric Urology
- Surgical Outcomes
- Renal Function Preservation
Background:
- Ureteropelvic junction obstruction (UPJO) is a common pediatric urological condition.
- Management of UPJO in poorly functioning kidneys remains debated.
- Differential renal function (DRF) is a key indicator of kidney function.
Purpose of the Study:
- To evaluate the outcomes of pyeloplasty in children with UPJO and low DRF (≤20%).
- To assess predictors of improved DRF and hydronephrosis (HN) after pyeloplasty.
Main Methods:
- Retrospective analysis of 218 children with congenital UPJO.
- Inclusion criteria: primary unilateral UPJO, DRF ≤20%.
- All patients underwent open dismembered pyeloplasty with stenting.
Main Results:
- 21 patients (median age 2 years) were included; median follow-up 2.5 years.
- 16/21 patients showed improved hydronephrosis post-surgery.
- 8/21 patients had DRF improvement of 10-15%; others showed stable DRF with non-obstructive curves.
Conclusions:
- Pyeloplasty yields favorable outcomes in children with unilateral UPJO and DRF ≤20%.
- Improvement in hydronephrosis on early postoperative renal ultrasound is a positive prognostic indicator.
- No significant preoperative predictors for improved DRF or HN were identified.
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