The Outcome Of Renal Function And Influencing Factors In Congenital Ureteropelvic Junction Obstruction After Pyeloplasty

Purpose: By observing children with moderate and severe hydronephrosis in children after pyeloplasty recovery of renal function and analysing the impact factors of renal function recovery, to provide clinical guidance for the treatment of pelviureteric junction obstruction(PUJO) in children, and further improve the prognosis of the patients .Methods and Materials: A retrospective analysis of 33 cases with moderate and severe hydronephrosis result form PUJO in children, which differenital renal function(DRF) was measured preoperatively by ECT。All cases were followed-up by ECT, IVU, B ultrasonography after pyeloplasty. Comparison of preoperative and postoperative renal function and analyse the impact factors of renal function recovery. Multivariate analysis of postoperative renal function was performed using multiple regression and logistic regression model.Results: In 33 cases of Hydronephrosis, preoperative DRF show negative correlation with hydronephrosis degree (-0.564, P = 0.001). The mean value of postoperative renal function was (39.52±9.15)% for 33 cases of patients receiving follow-up, of which 60.6% cases≥40% after pyeloplasty, the calculated postoperative DRF was a statistically significantly higer value of (8.96±7.94)% than preoperative DRF(P <0.05 ). For multivariate analyses, Postoperative recovery of renal function showed negatively correlated with preoperative renal function(r =- 0.452, P <0.05) and renal parenchymal thickness(r =- 0.118, P <0.05), while a positive correlation with the follow-up period (r = 0.518, P = 0.008), and no significant correlated with age (P = 0.556). Logistic analyses showed renal pelvis shape was a impact factor for recovery of renal function(P=0.013), while the clinical symptoms was not a impact factor(P=0.928) .Conclusion: In patients with PUJO, deteriorated renal function could improve to a certain extent, more than half of patients can recover to normal. preoperative DRF≥40% of patients, if the obstruction is not clear, could be closely followed up; while preoperative DRF <40% of patients needing immediately pyeloplasty in order to protect the function of kidney; preoperative DRF <10% of the patients ,carring out nephrectomy must to be cautious. Preoperative renal parenchymal thickness, preoperative renal function and postoperativ followed-up time, were relate to the increase value of postoperative renal function. Renal pelvis shape affect postoperative recovery of renal function .