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Pediatrics(구연)
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International Session I (I-05)
Rm. 202
10월 31일(목) 15:00-16:00
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Do we understand the supranormal DRF well? |
¹Tashkent Pediatric Medical Institute, Tashkent, Uzbekistan
²Pusan National University Childrens Hospital, Yangsan, South Korea |
| Saidanvar Agzamkhodjaev¹², Zafar Abdullaev¹², Jae Min Chung², Sang Don Lee² |
Purpose
Supranormal DRF seems to be renal hyperfunction due hyronephrosis and kidney enlargement. To perform the comparative analysis of outcomes of pyeloplasty in children with different types of differential renal function (DRF) to understand the true nature of supranormal DRF.
Material and methods
In this retrospective study, we analyzed medical records of 46 patients, who underwent pyeloplasty at single center in period between March 2009 and July 2018. Patients with bilateral hydronephrosis and other urological conditions were excluded from this study. According to preoperative differential renal function (DRF), patients were divided into three groups (group 1: DRF >55%, group 2: DRF 45-55%, and group 3: DRF <45%). In all patients pre and postoperative diuretic renal scan and US findings, such as a DRF, curve pattern, T1/2, grade of hydronephrosis, APD and parenchymal thickness were analyzed. Success outcome was defined as an improvement of both diuretic renal scan and US findings.
Results
The mean follow up period was 6734 (11-120) months. Mean age of patients at the time of surgery was 40±47 months. Of 46 renal units, 37 renal units had an obstructive curve pattern and 9 patients had equivocal curve pattern at preoperative diuretic renal scans. From the overall 46 renal units, in group 1, 2 and 3 were 9 (19.6%), 31 (67.4%) and 6 (13.0%) patients, respectively. Mean preoperative DRF was 62±3.9% in group 1, 51±3.0% in group 2 and 32±10.7% in group 3. In all groups, other preoperative characteristics were similar including curve pattern, T1/2, APD and parenchymal thickness. Overall fate of group 1 showed reduction of DRF in 5 (56%) patients, in group 2 in 13 (42%) and group 3 2 (33%) patients. Among 3 groups, postoperative curve pattern, APD and parenchymal thickness were improved in group 1 and 2 with significant difference from group 3 (p<0.05). The overall success rate was 89.1% (41/46). And no one patient from group 1 had an aggravation or failed pyeloplasty.
Conclusions
Supranormal DRF is more favorable then decreased DRF, but more depth studies are needed to completely understand the true nature of supranormal DRF. |
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keywords : Hydronephrosis, ureteral obstruction, pediatric, outcome |
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