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Renal abnormalities in children with hypertrophic pyloric stenosis--fact or fallacy?
1Department of Radiology, Northwestern University Medical School, Chicago, Illinois.
Insights
This study investigated renal disease in infants screened for hypertrophic pyloric stenosis (HPS). Newly diagnosed, medically important renal lesions were found in 2.4% of these pediatric patients, with similar incidence in those with and without HPS.
Area of Science:
- Pediatric Radiology
- Nephrology
- Gastroenterology
Background:
- Previous reports suggested a potential link between hypertrophic pyloric stenosis (HPS) and increased renal disease incidence.
- Abdominal ultrasound (US) is a primary imaging modality for diagnosing HPS in infants.
Purpose of the Study:
- To evaluate the incidence of renal abnormalities in children undergoing abdominal US for suspected hypertrophic pyloric stenosis (HPS).
- To determine if medically important renal lesions are more common in infants with HPS compared to those without.
Main Methods:
- Retrospective review of abdominal ultrasound examinations for 274 pediatric patients.
- Analysis of renal abnormalities detected in children with and without a diagnosis of HPS.
Main Results:
- Five major renal abnormalities were identified in 126 children with HPS (3 newly diagnosed).
- Three newly diagnosed, medically important renal lesions were found in 148 children without HPS.
- The incidence of newly diagnosed, medically important renal lesions was 2.4% in children screened for HPS, with no significant difference between groups.
Conclusions:
- The incidence of newly diagnosed, medically important renal lesions in infants screened for HPS is low (2.4%).
- There is no statistically significant increased incidence of renal disease in children with HPS compared to those without.
- Routine abdominal US for HPS does not appear to reveal a disproportionately high rate of significant renal pathology.
Abstract:
Retrospective review of the abdominal ultrasound (US) examination of 274 children studied for hypertrophic pyloric stenosis (HPS) was undertaken to determine if there is an increased incidence of renal disease as previously reported. Five major abnormalities were detected in the 126 children with HPS. Three lesions were newly diagnosed and two had been diagnosed previously. Five children had abnormalities classified as minor or normal variants. Renal abnormalities were found in six of the 148 children who did not HPS. Only three of these were newly diagnosed and medically important. Eight children without HPS had minor abnormalities or normal variants of the kidneys. Newly diagnosed medically important renal lesions were present in 2.4% of children screened for HPS. The incidence of the finding was the similar in children with and without HPS.