Materiały źródłowe

• #1 Hydronephrosis and Hydroureter – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK563217/

  Hydronephrosis is present in a growing number of neonates and infants, most commonly due to ureteropelvic junction obstruction. This is found in up to 1 in 100 live births in the United States and is treated conservatively. […] Nephrolithiasis is the most common cause of hydroureteronephrosis in young adults. Approximately 600,000 adults in the US suffer kidney stones per year, affecting nearly 1 in 11 persons. […] Hydronephrosis is commonly seen in up to 80% of pregnant women. […] Hydronephrosis is more common in women for the age range 20-60 due to pregnancy and gynecologic malignancy. For the age group greater than 60, it becomes more common in men due to prostate disease and complications.

• #1 Hydronephrosis: Causes, Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/15417-hydronephrosis

  Hydronephrosis can occur in people of all ages. It occurs in about 1 in 100 adults at some point in their life. […] In infants, its often due to an obstruction (blockage) that happens during fetal development (antenatal hydronephrosis). This occurs in up to 1% of all pregnancies. It usually resolves on its own before birth. […] A healthcare provider can detect hydronephrosis in a fetus as early as the first trimester on an ultrasound. Its typically discovered during a 20-week ultrasound. A diagnosis at this time usually means the birth mother needs additional ultrasounds to monitor the fetus. However, most cases resolve on their own.

• #1 Hydronephrosis and Hydroureter: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/436259-overview

  An autopsy series of 59,064 subjects ranging in age from neonates to geriatric persons reported hydronephrosis in 3.1%. […] In this series, differences based on sex did not become apparent until age 20 years. At age 20-60 years, hydronephrosis was more common in women, possibly because of pregnancy and gynecologic malignancy. In men, prostatic diseases were indicated as the cause of the rise in prevalence after age 60 years. Autopsy studies also indicate that hydronephrosis is present in 2-2.5% of children. […] The prevalence is slightly higher in boys, most of whom in the study were younger than 1 year. […] These occurrence rates likely underestimate the prevalence because conditions such as temporary obstruction due to prior pregnancy or calculi were not included. […] In a study that included 112 patients who underwent percutaneous nephrolithotomy, renal ultrasonography performed 4 – 6 weeks after stent removal, clinically silent hydronephrosis was identified in 16%. The hydronephrosis resolved spontaneously in 50% of cases, with a mean time to resolution of 6.3 months.

• #1 Hydronephrosis epidemiology and demographics – wikidoc

  https://www.wikidoc.org/index.php/Hydronephrosis_epidemiology_and_demographics

  The incidence and prevalence of hydronephrosis varies according to the underlying cause. Case fatality rate of hydronephrosis is 3.1 per 100 000 individuals. […] The incidence of hydronephrosis varies according to the underlying cause: Incidence of hydronephrosis following semirigid ureteroscopy was 17.8% […] Incidence of hydronephrosis following percutaneous nephrolithotomy is 16% […] The prevalence of hydronephrosis depends on the underlying cause. […] The prevalence of hydronephrosis secondary to appendicitis is 3.5% […] The case-fatality rate/mortality rate of hydronephrosis is approximately 3.1 per 100 000 individuals […] Patients of all age groups may develop hydronephrosis. […] There is no racial predilection to hydronephrosis. […] In younger patients (aged 20-60 years) frequency of hydronephrosis is higher in women than men. […] Older patients (60) frequency of hydronephrosis is higher in men than women. […] There is no specific regional distribution to hydronephrosis.

• #1 Investigation and management of antenatally detected hydronephrosis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2645869/

  Antenatal hydronephrosis (ANH) affects approximately 1% of pregnancies. […] The antenatal follow-up of ANH is determined by the severity of the diagnosis. […] The role of prophylactic antibiotics in children with ANH who are awaiting completion of post-natal investigations is controversial. […] All children with ANH should have a postnatal RUS. […] The need to further investigate mild postnatal hydronephrosis (SFU 0II) with a VCUG is controversial, and depends on the physicians attitude toward diagnosing asymptomatic VUR. […] Persistent moderate or severe hydronephrosis (SFU IIIIV) should be investigated with a VCUG, followed by diuretic renography if the hydronephrosis cannot be explained by VUR.

• #1 Revised guidelines on management of antenatal hydronephrosis – Indian Journal of Nephrology

  https://indianjnephrol.org/revised-guidelines-on-management-of-antenatal-hydronephrosis/

  Widespread antenatal screening has resulted in increased detection of anomalies of the kidneys and urinary tract. Depending on diagnostic criteria and gestation, the prevalence of antenatally detected hydronephrosis (ANH) ranges from 0.6 to 5.4%. The condition is bilateral in 17-54% and additional abnormalities are occasionally associated. The outcome of ANH depends on the underlying etiology. Although ANH resolves by birth or during infancy in 41-88% patients, urological abnormalities requiring intervention are identified in 4.1-15.4% and rates of vesicoureteric reflux (VUR) and urinary tract infections (UTI) are several-fold higher. It is important to distinguish infants with significant illness that require long-term follow-up or surgery, from those with transient hydronephrosis and minimum need for invasive investigations.

• #1 Antenatal Urinary Tract Dilation (Hydronephrosis): Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/1016305-overview

  UTD is the most common pathologic finding in the urinary tract on antenatal screening by US, accounting for 50% of all abnormal findings. The incidence varies among series because of criteria for dilatation and timing of US; however, the incidence of a significant uropathy in association with UTD is 0.2%. […] International studies have supported a similar incidence, with an incidence of 0.25% in Sweden and 0.92% in Great Britain. […] Studies have uniformly shown that the timing of UTD is important. Early onset of UTD in fetal development is directly related to prognosis. The incidence of this condition in relation to sex has not been reported. No known studies have reported the incidence of antenatal UTD related to race.

• #1 Hydronephrosis | Texas Children’s

  https://www.texaschildrens.org/content/conditions/hydronephrosis

  Hydronephrosis is caused when urine flow is blocked, making the kidneys swell. Swelling usually affects only 1 kidney (unilateral), but it can affect both (bilateral). This condition can also be accompanied by swelling of the ureter (hydroureter). […] Hydronephrosis is the most common urological problem found during prenatal ultrasound screening. As many as 42,000 fetuses (1.4% of all fetuses) are diagnosed with hydronephrosis each year. […] Generally, about 25% of children who have improper function or poor kidney drainage will require surgical intervention.

• #1 Hydronephrosis | UNC Department of Urology

  https://www.med.unc.edu/urology/pediatrics/pediatric-conditions/hydronephrosis/

  Hydronephrosis is very common. It affects about 1 in 100 babies. […] Hydronephrosis is often found on routine prenatal ultrasounds. It is the most common urinary tract abnormality found on prenatal ultrasound imaging. […] Hydronephrosis is usually detected with an ultrasound but there is a different approach between pre- and post-natal diagnosis. […] In more than half of the children with hydronephrosis, the dilation resolves without any treatment. In these cases, the cause is never known. […] To date, there are no known risk factors for hydronephrosis. However, boys are four-to-five times more likely to be born with hydronephrosis than girls. […] The most common complication of hydronephrosis is the development of a urinary tract infection (UTI). […] Children with severe hydronephrosis (moderate-severe, grade 3 and 4) have a higher risk of UTI/pyelonephritis.

• #1 Giant Hydronephrosis – A Late Diagnosis of Ureteropelvic Junction Obstruction | Sepulveda | World Journal of Nephrology and Urology

  https://wjnu.org/index.php/wjnu/article/view/95/73

  Ureteropelvic junction obstruction is the most common cause of neonatal hydronephrosis, with an overall incidence of 1:1,500. […] With an overall incidence of 1:1,500, it is the most common cause of neonatal hydronephrosis. […] Nowadays most cases of UPJ obstruction are suspected during pregnancy due to the recent widespread use of ultrasonography in the antenatal period, especially after the 28th week when it is most accurate to study the urogenital tract. […] Despite most patients being diagnosed in the early years, there are still cases of late diagnosis, including in adulthood, usually associated to an asymptomatic evolution. […] The delay in detection of UPJ obstruction can lead to progressive and severe hydronephrosis and loss of function of the affected kidney at the time of diagnosis.

• #1 The correlation between GFR and unit renal volume in infants with hydronephrosis measured by two imaging methods | Scientific Reports

  https://www.nature.com/articles/s41598-023-46996-y

  The incidence of congenital hydronephrosis in children is approximately 0.130.16%, with a higher prevalence in boys, and infants account for 25% of cases. […] The occurrence of congenital hydronephrosis is more commonly seen on the left kidney, which account for up to 2/3 of newborns, while bilateral involvement occurs in about 1040%. […] However, a minority may experience worsening symptoms which significantly increase their risk for impaired renal function. […] Hence, closely monitoring the patients with non-physiological hydronephrosis allows early detection followed by timely intervention. […] Given that the renal function in infants correlates closely with kidney size, evaluating both size and function of the kidney through measuring kidney length has become a common approach.

• #1 Hydronephrosis and Hydroureter: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/436259-overview

  In women, gynecologic cancers and pregnancy are common causes. As such, among younger patients (aged 20-60 y), the frequency of hydronephrosis is higher in women than in men. […] In men, obstruction secondary to prostatic hypertrophy and prostate cancer are the major causes of hydronephrosis. Consequently, among older patients (60 y), the frequency of hydronephrosis is higher in men than in women. […] In young adults, calculi are the most common causes of hydroureter and hydronephrosis. […] In children and in neonates, the relative frequency of the causes of antenatal hydronephrosis has been determined to be as follows: Transient – 48%, Physiologic -15%, Ureteropelvic junction obstruction – 11%, Vesicoureteral reflux – 9%, Megaureter – 4%, Multicystic dysplastic kidney – 2%, Ureterocele – 2%, Posterior urethral valves – 1%.

• #1 Kidney Stones: Treatment and Prevention | AAFP

  https://www.aafp.org/pubs/afp/issues/2019/0415/p490.html

  The prevalence of nephrolithiasis (kidney stones) is increasing in the United States, from one in 20 adults in 1994 to one in 11 adults in 2010. Worldwide, it is also increasing in Europe and is even higher in the hot-climate stone belt extending from the southeastern United States to northern Australia. Increasing exposure to these risk factors may explain the rising incidence of kidney stones and their prevalence in men, non-Hispanic whites, and persons with low socioeconomic status. The annual incidence of kidney stones is about eight cases per 1,000 adults and peaks around midlife in developed countries. […] When immediate referral is not indicated, urine culture and urinalysis (if not already done) should be ordered to rule out infection, as well as imaging to confirm the diagnosis of kidney stones and assess for hydronephrosis and stone size and position. Referral to a urologist for active stone removal is warranted when the stone is larger than 10 mm or if significant hydronephrosis is present. […] Patients at risk of stone recurrence should be referred for additional metabolic testing (e.g., 24-hour urine collection for total volume, pH, and calcium oxalate, uric acid, citrate, sodium, potassium, and creatinine levels) and individualized preventive measures.

• #1 Hydronephrosis – Symptoms, Causes, Complications, Treatment PACE Hospitals – Best Hospitals in Hitech City, Hyderabad, India | Near Madhapur, Kukatpally, KPHB, Kondapur, Gachibowli, Jubilee Hills, Banjara HillsPACE Hospitals Contact Numbe

  https://www.pacehospital.com/hydronephrosis-symptoms-causes-complications-treatment-prevention

  Hydronephrosis is characterized by the enlargement and stretching of one or both kidneys due to urine buildup within them. This condition can affect individuals across all age groups, and is occasionally detected in unborn babies during standard pregnancy ultrasound screenings, referred to as antenatal hydronephrosis. If hydronephrosis is identified early and treated appropriately by a urologist/nephrologist, it usually does not result in any long-term issues. […] Every year, an estimated 6% of all new births (80 lakhs) are born with significant birth defects, with up to 1% having kidney and urinary tract congenital disorders. Hydronephrosis is becoming more common in neonates and infants, and it is usually caused by ureteropelvic junction blockage. Hydronephrosis occurs in up to 80% of pregnant women. Mechanical compression of the ureters caused by the expanding uterus, as well as the effects of progesterone, are likely to be the cause. It is usually detected in the second trimester and might last for 6 to 12 weeks after birth. If patients suffer discomfort and renal failure, ureteral stenting is the preferred therapy option. […] Hydronephrosis is more common in women aged 20 to 60 because of pregnancy and gynaecologic malignancy. Men over the age of 60 are more likely to develop hydronephrosis due to prostate disease and its consequences.

• #1 Maternal hydronephrosis in pregnancy | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/maternal-hydronephrosis-in-pregnancy?lang=us

  It is estimated that up to 90% of women have some degree of asymptomatic dilatation of the renal calyces, the renal pelves and the upper two-thirds of the ureters during pregnancy. It is thought to be most pronounced in primigravid females. […] The prevalence of ureteric calculi in pregnancy is low and is estimated around 0.03-0.4% depending on the population. […] There may be an association between gestational hydronephrosis and increased frequency of ascending urinary tract infection.

• #1 Hydronephrosis | UNC Department of Urology

  https://www.med.unc.edu/urology/pediatrics/pediatric-conditions/hydronephrosis/

  Identifying the cause of your child’s hydronephrosis will help determine how to follow or treat it. […] If your baby is diagnosed with hydronephrosis, there’s a few things to remember. First, many children who are diagnosed with hydronephrosis prenatally have no evidence of hydronephrosis before they are born or at follow up after birth.

• #1 Prevalence and aetiology of Hydronephrosis in adults

  https://doi.org/10.5281/zenodo.7496125

  Hydronephrosis is usually caused by an underlying medical condition or risk occasionally as congenital blockage, unilateral obstructive uropathy, kidney stones, UTIs, tissue scarring, blood clots, neuromuscular problems, Cancer or BPH and pregnancy. This current study was directed to determine the etiological factors and prevalence causes of Hydronephrosis […] This study included 213 patients, with those aged 41-50 years (45%) having the highest prevalence of hydronephrosis. Gender Includes 30% females and 70% males. About 86% had Hydronephrosis in Unilateral kidney and 13% in bilateral kidneys. The grading of Hydronephrosis was found as highest in Grade2: 122 (57.3%). The causes of Hydronephrosis were observed on Ultrasound and found most prevalent cases of Calculi 60%, 13% females had Hydronephrosis due to Pregnancy, 8.9% males had Hydronephrosis due to Benign Prostatic Hyperplasia. […] The study concluded that Renal Calculi are the most prevalent cause of Hydronephrosis followed Pregnancy and BPH.

• #1 Etiology of Hydronephrosis in Neonates

  https://brieflands.com/articles/num-65307.html

  Hydronephrosis as a major health issue, has a significant contribution to the loss of kidney function and dialysis. […] In total 314 infants with hydronephrosis (55.7% male and 44.3% female) were included. Idiopathic cause (42%) as the most common etiology and vesicoureteric reflux as 2nd most common etiology of hydronephrosis have been evaluated (37.4%). […] Based on this finding, different causes can induce hydronephrosis as a different etiology; therefore, we can control and reduce hydronephrosis by checking vesicoureteric reflux as the most common possible etiology. […] Our results showed etiology prevalence in hydronephrosis and its correlation with different factors such as gender, gestational age amniotic fluid volume, hydronephrosis severity, birth weight, familial history, and severity of hydronephrosis. […] VUR is the most common etiology of hydronephrosis in neonates. Therefore, we can control and reduce hydronephrosis by checking VUR as the most common possible etiology.

• #1 Revised guidelines on management of antenatal hydronephrosis – Indian Journal of Nephrology

  https://indianjnephrol.org/revised-guidelines-on-management-of-antenatal-hydronephrosis/

  Guidelines from the Indian Society of Pediatric Nephrology (ISPN) on management of ANH were published in 2000. During the last decade, there is better understanding regarding its often benign natural history and risk factors for postnatal pathology. Recommendations from other expert groups, including the Society for Fetal Urology (SFU) have been published. This document revises the ISPN guidelines and has been simultaneously published in the February 2013 issue of the Indian Pediatrics. […] The gestation at which hydronephrosis is detected and its course on sequential ultrasound scans has prognostic value. Almost 80% of fetuses diagnosed in the second trimester show resolution or improvement of findings with low likelihood of postnatal sequelae. Patients with persistence or worsening hydronephrosis in the third trimester show higher rates of postnatal pathology and require close follow-up.

• #1 Revised guidelines on management of antenatal hydronephrosis – Indian Journal of Nephrology

  https://indianjnephrol.org/revised-guidelines-on-management-of-antenatal-hydronephrosis/

  The risk of in utero worsening is higher for bilateral than for unilateral disease. While a recent report suggests that patients with mild to moderate isolated bilateral hydronephrosis have a favorable outcome, close follow-up is necessary since a proportion may show progression or require surgery. […] The initial evaluation aims to detect patients with bladder obstruction, which requires prompt intervention. Decisions regarding surgical intervention, in other patients with obstructive hydronephrosis, depend on a combination of clinical and laboratory features, and results of sequential ultrasonography and diuretic renography.

• #1 Hydronephrosis – Children’s Hospital of Orange County

  https://choc.org/programs-services/urology/hydronephrosis/

  Hydronephrosis is a common congenital condition that is found in about one out of every 500 babies. […] Today, hydronephrosis is usually first diagnosed on prenatal ultrasounds. Finding hydronephrosis while the baby is the womb has become more common because of advances in prenatal ultrasounds. […] Hydronephrosis is most commonly diagnosed on routine prenatal ultrasounds completed after 10 weeks of gestation. […] The Society for Fetal Urology has created a universal grading system of hydronephrosis that ranges from grade 1 (most mild) to grade 5 (most severe). […] Children with hydronephrosis typically lead normal lives, as most cases of the condition resolve early in their life, often without long-term consequence.

• #1 Update on the Postnatal Management of Antenatal Hydronephrosis – American Urological Association

  https://auanews.net/issues/articles/2022/february-2022/update-on-the-postnatal-management-of-antenatal-hydronephrosis

  Perinatal urinary tract dilation (UTD), or hydronephrosis, occurs in approximately 1% of all pregnancies and may be attributed to transient dilation, vesicoureteral reflux (VUR) or an obstructive uropathy. […] The Urinary Tract Dilation classification system was developed in 2014 by specialists in multiple fields in an effort to standardize nomenclature for the grading of UTD across the prenatal and postnatal continuum. […] Postnatal recommendations are based on this assigned level of risk and guide the use of CAP, need for subspecialist referral, appropriate interval of surveillance renal ultrasonography and the need for additional imaging. […] Historical data on the benefits of CAP in prevention of UTI in patients with UTD are conflicting and derived from retrospective or single-center reviews.

• #1 Update on the Postnatal Management of Antenatal Hydronephrosis – American Urological Association

  https://auanews.net/issues/articles/2022/february-2022/update-on-the-postnatal-management-of-antenatal-hydronephrosis

  Recent data from the multicenter prospective SFU hydronephrosis registry demonstrated two important findings which include a significant benefit of CAP in those patients with ureteral dilation >7 mm and no benefit for isolated ureteropelvic junction-like hydronephrosis. […] The development of the UTD risk stratification system combined with recent prospective data from the SFU multicenter Hydronephrosis Registry has allowed providers to make evidence-based management decisions for patients.

• #1 The Hydronephrosis Severity Index guides paediatric antenatal hydronephrosis management based on artificial intelligence applied to ultrasound images alone | Scientific Reports

  https://www.nature.com/articles/s41598-024-72271-9

  Antenatal hydronephrosis (HN) impacts up to 5% of pregnancies and requires close, frequent follow-up monitoring to determine who may benefit from surgical intervention. […] The model was developed and studied at four large quaternary free-standing paediatric hospitals in North America. […] HN severity can be predicted from a single patient ultrasound using a novel image-based artificial intelligence system. […] The challenge is to risk-stratify patients early in life. However this is currently not possible, therefore babies with HN are monitored with serial ultrasounds, and many will undergo invasive testing, requiring urethral catheterization, intravenous access, and exposure to radioisotopes and radiation. […] Risk stratification using ultrasound images alone has the potential to streamline care for low-risk patients, reduce the number of patients investigated with invasive tests and help providers to comply with the as low as reasonably achievable (ALARA) radiation principle, while expediting interventions for those that may benefit.

• #1 The Hydronephrosis Severity Index guides paediatric antenatal hydronephrosis management based on artificial intelligence applied to ultrasound images alone | Scientific Reports

  https://www.nature.com/articles/s41598-024-72271-9

  We built a model to estimate risk of requiring surgery for patients with HN directly from ultrasound images. […] We propose that different HSI thresholds can be used toward different clinical management decisions at individual institutions or clinical settings. […] The HSI model was trained using a retrospectively-collected dataset of 1938 ultrasound images for 403 patients and their linked health records from SickKids. […] The model performance when applied to the Stanford dataset was 89% sensitive and 73% specific (99% NPV, 15% PPV), to the UIowa dataset, 96% sensitive and 54% specific (92% NPV, 74% PPV), and to the CHOP dataset, 82% sensitive and 79% specific (68% NPV, 89% PPV). […] The model presented here can be used to develop multiple institution-specific models with far fewer training samples than were required for the original model.

• #1 Hydronephrosis: Causes, Symptoms, and Diagnosis

  https://www.healthline.com/health/unilateral-hydronephrosis

  Hydronephrosis is said to affect about 1 in every 100 babies. […] Getting a diagnosis as early as possible is extremely important. Your kidneys could be permanently damaged if your condition is left untreated for too long. […] Both of these procedures let your doctor view an image of the inside of your body, but the renal ultrasound is generally considered the gold standard for the diagnosis of hydronephrosis. […] If you receive treatment early, your outlook is good. Removal of the obstruction is essential for your kidney to return to normal functioning. If your hydronephrosis requires surgery, the success rate to having a full recovery is estimated at 95 percent.

• #1 Prenatal Hydronephrosis (Urinary Tract Dilation) | National Kidney Foundation

  https://www.kidney.org/kidney-topics/prenatal-hydronephrosis-urinary-tract-dilation

  Prenatal hydronephrosis is relatively common, affecting about 1 in 100 babies. In fact, it is the most common problem found on a prenatal ultrasound. […] Hydronephrosis is most commonly diagnosed on a routine prenatal ultrasound. In these cases, an ultrasound is done after birth to see if hydronephrosis persists. […] Most cases of mild and moderate hydronephrosis need only periodic monitoring with kidney and bladder ultrasounds. The ultrasounds will show the degree of hydronephrosis and whether it is stable, improving or worsening. […] In some cases, hydronephrosis that is severe or left untreated can cause urinary tract infections, kidney scarring, and loss of kidney function that may cause long-term problems.

• #1 Hydronephrosis Causes, Symptoms, and Treatment Options

  https://www.upmc.com/services/womens-health/conditions/hydronephrosis

  Hydronephrosis affects about 1% of babies and 1% of adults. […] Its important to get treatment as soon as possible to avoid any permanent damage to the kidneys. Severe hydronephrosis can lead to kidney failure, which may then require dialysis or a kidney transplant. […] Most people recover from hydronephrosis with prompt treatment.

• #1 What Is Hydronephrosis?

  https://www.icliniq.com/articles/kidney-and-urologic-diseases/hydronephrosis

  Hydronephrosis can occur at any age without any gender prediction. In children, it is most commonly due to obstruction caused by anatomical defects. Whereas in adults, it occurs mostly as a result of kidney stones obstructing urine drainage. Antenatal hydronephrosis is reported to be present at least 1 in every 100 pregnancies. […] Hydronephrosis is an easily manageable condition; the prime aim of treatment should be focused on removing the excess urine and relieving the pressure. If left untreated, it may cause permanent kidney damage leading to renal failure. Promptly treating the underlying cause reduces the chance of developing hydronephrosis. The overall prognosis of hydronephrosis is reported to be good.

• #1 Hydronephrosis | Symptoms, Diagnosis & Treatment

  https://www.cincinnatichildrens.org/health/h/hydronephrosis

  Hydronephrosis in infants may appear before a baby is born. About 1% to 5% of prenatal ultrasounds show signs of hydronephrosis in pregnancy. […] Pediatric hydronephrosis can be found before birth or after birth. Fetal hydronephrosis is the most common urinary tract issue found during a routine ultrasound. […] Some infants or young children with hydronephrosis need more testing. They may need magnetic resonance imaging (MRI), a special X-ray or a renal scan. Diagnosing an underlying condition can help find the best treatment options, if needed. […] For mild and moderate hydronephrosis, it is very likely the condition will improve over time on its own. It should not cause future damage to the kidneys. For severe hydronephrosis, providers may need to watch it more closely. The goal is to prevent any hydronephrosis complications that put the kidneys at risk.

• #1 Asymptomatic obstructive hydronephrosis associated with diabetes insipidus: a case report and review – Sun – Translational Pediatrics

  https://tp.amegroups.org/article/view/71728/html

  Attention should be paid to children with mild hydronephrosis undergoing regular observation and conservative treatment as a sudden aggravation of hydronephrosis and rapid decline of renal function may occur if DI persists. […] However, there are no studies or guidelines that indicate the specific follow-up intervals and surgical indications for mild hydronephrosis if predisposing risk factors persist. […] It remains controversial that whether surgical intervention at an early stage is necessary in order to avoid renal function decline. […] The suitable time and exact indications for surgical intervention are complex and remain controversial. […] The indications for surgical intervention include: deterioration of hydronephrosis, decline of split renal function 10%, split renal function 40%, obstruction curve on DR, or febrile urinary tract infection.

• #1 Management of hydronephrosis: a comprehensive review in pediatric urology perspective

  https://www.chikd.org/journal/view.php?number=808

  Hydronephrosis, characterized by dilation of the renal pelvis and calyces due to urine flow obstruction, poses a significant clinical challenge. […] Hydronephrosis represents a wide spectrum of urological conditions ranging from mild anomalies such as transient dilation of the collecting system to more important anomalies such as high-grade congenital vesicoureteral reflux (VUR), ureteropelvic junction obstruction (UPJO), and primary obstructive megaureter (POM). […] Hydronephrosis may increase the risk of urinary tract infections (UTI) in children, especially during the first 2 years of life. […] The European Association of Urology guidelines recommend surgery as the treatment of choice in patients with symptomatic UPJO. […] In summary, symptomatic patients (such as UTI and flank pain) in both of UPJO and POM are absolute indications for surgery, and in addition, if there is a decrease in renal function more than 10% during follow-up, worsening hydronephrosis, or poor renal function from the initial examination, a referral to a urologist is required.

• #1 Asymptomatic obstructive hydronephrosis associated with diabetes insipidus: a case report and review – Sun – Translational Pediatrics

  https://tp.amegroups.org/article/view/71728/html

  The clinical/surgical approach has changed a lot and plays a positive role in the preservation of renal function. […] The identification of these asymptomatic prenatal hydronephrosis may minimize renal damage with regular follow-up. […] For the purpose of monitoring hydronephrosis and protecting renal function, follow-up ultrasound performed every 12 weeks may be appropriate for patients with asymptomatic SFU grade 12 hydronephrosis if there are any factors that may lead to the exacerbation of hydronephrosis, as clinical symptoms may be inconsistent with imaging findings in these patients. […] It is worth noting that hydronephrosis and/or deterioration of renal function may recur a few years after spontaneous resolution of hydronephrosis, and it is usually accompanied by symptoms, such as abdominal pain, nausea, vomiting, and hematuria.

• #1

  https://journals.lww.com/auajuro/fulltext/2021/09001/mp47_03_virtual_or_in_person__parent_attitudes.1758.aspx

  Telemedicine is rapidly being implemented as an alternative to in-person visits, lowering cost while promoting high quality, accessible care. […] We surveyed parents of children with hydronephrosis to identify factors associated with preference for telemedicine. […] In an era of increased utilization, telemedicine is of interest to parents of children with hydronephrosis. […] While this study focused on tertiary hospital visits, our findings suggest that future studies inclusive of outreach clinics or rural areas may magnify demand for telemedicine and highlight a need for equitable access to an emerging modality of care.

• #1 Deneysel ve Klinik Tıp Dergisi » Submission » Epidemiological and clinical characteristics, management, and outcomes of antenatal hydronephrosis: a single-center experience of 229 cases

  https://dergipark.org.tr/en/pub/omujecm/issue/76176/1252532

  The advances in utilization of USG in antenatal routine follow-up resulted with increased diagnosis of antenatal hydronephrosis (ANH). This study was conducted to elaborate the epidemiological and clinical characteristics, management, outcomes, and possible risk factors of the ANH. A total of 229 cases diagnosed with ANH during the antenatal follow-up at the Obstetrics and Gynecology Department of OndokuzMayis University between 2004 and 2022 were included. […] The epidemiological and clinical characteristics, risk factors, treatment and outcomes in the postnatal period were assessed retrospectively. […] Male gender, increased gestational urinary tract infections, and family histories of parents for a kidney disease were found as possible risk factors for development of ANH.

• #1

  https://www.ijmedicine.com/index.php/ijam/article/view/519

  Left flank pain was slightly more than the right flank pain, although this was not found to be significant. […] There were 41 cases of hydronephrosis in total and all of them were positive for mean RI. […] The mean resistive index is a very good tool for the diagnosis of hydronephrosis, with a very high level of specificity and sensitivity.

• #2 Hydronephrosis and Hydroureter: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/436259-overview

  An autopsy series of 59,064 subjects ranging in age from neonates to geriatric persons reported hydronephrosis in 3.1%. […] In this series, differences based on sex did not become apparent until age 20 years. At age 20-60 years, hydronephrosis was more common in women, possibly because of pregnancy and gynecologic malignancy. In men, prostatic diseases were indicated as the cause of the rise in prevalence after age 60 years. Autopsy studies also indicate that hydronephrosis is present in 2-2.5% of children. […] The prevalence is slightly higher in boys, most of whom in the study were younger than 1 year. […] These occurrence rates likely underestimate the prevalence because conditions such as temporary obstruction due to prior pregnancy or calculi were not included. […] In a study that included 112 patients who underwent percutaneous nephrolithotomy, renal ultrasonography performed 4 – 6 weeks after stent removal, clinically silent hydronephrosis was identified in 16%. The hydronephrosis resolved spontaneously in 50% of cases, with a mean time to resolution of 6.3 months.

• #2 Hydronephrosis | Denver Urology Associates | Lone Tree

  https://www.denverurology.com/urology/hydronephrosis/

  Hydronephrosis is fairly common, affecting 1 in 100 people. […] It is not uncommon, occurring in 1 in 100 adults at some time in their lives. […] Hydronephrosis can occur in one kidney (unilateral hydronephrosis) or both kidneys.

• #2 Hydronephrosis | Children’s Hospital of Philadelphia

  https://www.chop.edu/conditions-diseases/hydronephrosis

  Prenatal hydronephrosis (which may also be called antenatal hydronephrosis, or fetal urinary tract dilation) is one of the most common fetal anomalies diagnosed before birth. […] Hydronephrosis is now found in 1 out of 100 pregnancies. […] This clinical pathway can be used to guide the evaluation and management of patients presenting with ultrasound findings of perinatal urinary tract dilation (UTD). This pathway should be used by pediatricians, neonatologists, and urologists to guide risk-based evaluation and treatment based on pre-natal and post-natal ultrasound findings.

• #2 Hydronephrosis and Hydroureter – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK563217/

  Hydronephrosis is present in a growing number of neonates and infants, most commonly due to ureteropelvic junction obstruction. This is found in up to 1 in 100 live births in the United States and is treated conservatively. […] Nephrolithiasis is the most common cause of hydroureteronephrosis in young adults. Approximately 600,000 adults in the US suffer kidney stones per year, affecting nearly 1 in 11 persons. […] Hydronephrosis is commonly seen in up to 80% of pregnant women. […] Hydronephrosis is more common in women for the age range 20-60 due to pregnancy and gynecologic malignancy. For the age group greater than 60, it becomes more common in men due to prostate disease and complications.

• #2 Hydronephrosis and Hydroureter: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/436259-overview

  In women, gynecologic cancers and pregnancy are common causes. As such, among younger patients (aged 20-60 y), the frequency of hydronephrosis is higher in women than in men. […] In men, obstruction secondary to prostatic hypertrophy and prostate cancer are the major causes of hydronephrosis. Consequently, among older patients (60 y), the frequency of hydronephrosis is higher in men than in women. […] In young adults, calculi are the most common causes of hydroureter and hydronephrosis. […] In children and in neonates, the relative frequency of the causes of antenatal hydronephrosis has been determined to be as follows: Transient – 48%, Physiologic -15%, Ureteropelvic junction obstruction – 11%, Vesicoureteral reflux – 9%, Megaureter – 4%, Multicystic dysplastic kidney – 2%, Ureterocele – 2%, Posterior urethral valves – 1%.

• #2 Maternal hydronephrosis in pregnancy | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/maternal-hydronephrosis-in-pregnancy?lang=us

  It is estimated that up to 90% of women have some degree of asymptomatic dilatation of the renal calyces, the renal pelves and the upper two-thirds of the ureters during pregnancy. It is thought to be most pronounced in primigravid females. […] The prevalence of ureteric calculi in pregnancy is low and is estimated around 0.03-0.4% depending on the population. […] There may be an association between gestational hydronephrosis and increased frequency of ascending urinary tract infection.

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