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Inception of novel equations for estimation of differential renal function changes after successful pyeloplasty in
Mustafa Abo Yaman1, Osama El Gamal2, Samir El Gamal2
1Urology Department, Damanhur Medical Institute, Damanhur, Egypt.
Insights
Successful pyeloplasty significantly improves pediatric hydronephrosis and renal function. Changes in renal pelvis diameter and parenchyma thickness predict postoperative split renal function and glomerular filtration rate improvements.
Area of Science:
- Pediatric Urology
- Nephrology
- Radiology
Background:
- Ureteropelvic junction obstruction is the leading cause of pediatric hydronephrosis.
- Anderson Hynes dismembered pyeloplasty is the standard surgical treatment.
Purpose of the Study:
- To identify factors influencing renal function improvement after pyeloplasty in children.
- To predict renal scan changes post-pyeloplasty using Tc-99m DTPA renography.
Main Methods:
- Retrospective study of pediatric patients (≤18 years) undergoing pyeloplasty (May 2018-May 2022).
- Utilized pelvic-abdominal ultrasonography and Tc-99m DTPA radioisotope scans.
Main Results:
- Postoperative pyeloplasty showed significant increases in renal parenchyma thickness, split renal function, and glomerular filtration rate (p<0.05).
- Decreased renal pelvis anteroposterior diameter correlated with improved renal function and parenchyma thickness.
- Developed a predictive equation for postoperative split renal function and glomerular filtration rate with high accuracy.
Conclusions:
- Pyeloplasty effectively improves hydronephrosis and renal parenchymal changes.
- Renal pelvis diameter and parenchymal thickness changes can predict postoperative renal function enhancement.
Introduction:
Ureteropelvic junction obstruction is the most common cause of pediatric hydronephrosis. Anderson Hynes dismembered pyeloplasty as the standard surgical treatment in such cases.
Purpose:
To evaluate and detect factors that affect renal function changes (improvement) after successful pyeloplasty using Tc-99 m Diethylenetriaminepentaacetic (DTPA) renography in children and to predict renal scan changes after successful pyeloplasty.
Methods:
This retrospective study was conducted on children ≤ 18 years of age who underwent successful pyeloplasty from May 2018 to May 2022. Pelvic-abdominal ultrasonography and radioisotope scan Tc-99 m DTPA were performed in all patients.
Results:
Postoperative group showed a significant increase in renal parenchyma thickness, split renal function, and glomerular filtration rate with a decreased renal pelvis anteroposterior diameter (p < 0.05). There was a significant correlation between each postoperative decrease in the anteroposterior diameter of the renal pelvis and the postoperative increase in parenchyma thickness with the postoperative increase in split renal function. The equation used to detect postoperative split renal function and glomerular filtration rate had a high detection rate.
Conclusions:
Pyeloplasty resulted in significant improvements in hydronephrosis, and renal parenchymal changes in association with renal pelvis diameter can predict Postoperative increase in split renal function and glomerular filtration rate.
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