Sonographic evaluation of hydronephrosis in the pediatric population: is well-tempered sonography necessary?

Journal of Ultrasound in Medicine : Official Journal of the American Institute of Ultrasound in Medicine
Marc R WalkerLeah P McMann

Abstract

Standardized protocols exist for diuretic renography. There are no specific guidelines regarding hydration before renal sonography. This study assessed the importance of the hydration status by sonographic measurements of the anteroposterior diameter and its effect on Society for Fetal Urology (SFU) hydronephrosis grading. Children aged 6 weeks to 16 years (mean age, 22 months) with unilateral SFU grade 3 or 4 hydronephrosis requiring diuretic renal scintigraphy were recruited to undergo prehydration and posthydration renal sonography. Hydrated diuretic renal scintigraphy, or "well-tempered" renography, was then performed. Renal sonograms were reviewed by a blinded pediatric radiologist and pediatric urologist. Two-sided statistical tests assessed whether SFU grades and the anteroposterior diameter changed significantly after hydration. Among 67 kidneys, the pediatric urologist (L.P.M.) and pediatric radiologist (V.J.R.) reported no SFU grade change in 45 (67%) and 52 (78%) kidneys after hydration. In kidneys that changed, the posthydration grade was more likely to be higher. This difference was statistically significant (14 of 22 and 13 of 15 differences were higher grades after hydration for L.P.M. and V.J.R., respectively; P...Continue Reading

References

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Aug 10, 2004·Pediatric Radiology·Maria Cândida Ferrarez BouzadaRicardo Parreiras
Dec 20, 2005·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Gagan SidhuNorman D Rosenblum
Mar 21, 2006·Journal of Clinical Ultrasound : JCU·Fatih KantarciOmer Uysal
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Apr 20, 2010·Journal of Pediatric Urology·Hiep T NguyenJeffrey B Campbell
Aug 6, 2013·Pediatric Radiology·Mooneera PeerboccusFreddy Avni

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