Child Kidney Dis.  2022 Jun;26(1):1-10. 10.3339/ckd.22.021.

Management strategies for congenital isolated hydronephrosis and the natural course of the disease

• Jung J
• Lee JH
• Kim KS
• Song SH
• Moon DH
• Yoon HM
• Cho YA
• Park YS

• KMID: 2531928
• DOI: http://doi.org/10.3339/ckd.22.021

Abstract

Congenital isolated hydronephrosis encompasses a spectrum of physiologic states that spontaneously resolve and pathologic obstruction that necessitates surgical intervention. Distinguishing patients whose condition will resolve, those who will require stringent follow-up, and those who will eventually need surgical intervention present a challenge to clinicians, particularly because no unified guidelines for assessment and follow-up have been established. The recognition of the natural course and prognosis of hydronephrosis and a comprehensive understanding of the currently proposed consensus guidelines may aid in multidisciplinary treatment and in providing proper counseling to caregivers. In this review, we aimed to summarize the literature on the grading systems and management strategies for congenital isolated hydronephrosis.

Keyword

Hydronephrosis; Resolution; Ureteropelvic junction obstruction; Pyeloplasty

Figure

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  Fig. 1. Society for Fetal Urology (SFU) hydronephrosis grading system. The SFU grading system is based on the degree of renal-pelvic and calyceal dilatation seen on renal ultrasonography images and the integrity of the renal parenchyma [12].

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  Fig. 2. Urinary tract dilation (UTD) classification system (postnatal categories). Although the UTD classification system has two antenatal categories (UTD-A1 and UTD-A2–3) and three postnatal categories (UTD-P1, UTD-P2, and UTD-P3) [8,16], only the postnatal categories (>48 hours) are presented here. APD, anteroposterior pelvic diameter. Adapted from Nguyen et al. [16] with permission from Springer.

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  Fig. 3. Onen grading system. The diagram summarizes the Onen grading system, reflecting the 2016 update on grades 3 and 4 [26]. APD, anteroposterior pelvic diameter.

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  Fig. 4. Suggested follow-up and management strategies for congenital isolated hydronephrosis. The diagram summarizes the proposed guidelines from the literature. USG, ultrasonography; SFU, Society for Fetal Urology; UTD, urinary tract dilatation; DRS, diuretic renal scan; VCUG, voiding cystourethrography; prn, pro re nata.

Reference

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