Predictive Factors Of Outcome And Observation Period In Children With Unilateral Hydronephrosis Which Caused By Ureteropelvic Junction Obstruction

Objective: To evaluate the association between the initial visit data including initial APD measured by ultrasonography(USG)and outcome of unilateral hydronephrosis caused by ureteropelvic junction obstruction(UPJO)in children.Methods: one hundred and ninety-three children with UPJO,who underwent the USG at the initial visit time,and at least 24-months follow-up for non-surgical populations were divided two groups according to the outcome.To evaluate the relation among the initial age,gender,side and initial hydronephrosis grade and prognosis of UPJO.Results: 1.Areas under the receiver operating characteristic plots(95 % CI)were 0.924(0.870–0.977),P<0.01;sensitivity,specificity,positive predictive value(PPV),and negative predictive value(NPV)were 87.2%,88.9%,87.5%,and 95.5%,respectively,for the APD of ?1.85 cm.2.Infancy and initial APD>1.5cm was the risk factors predicting operation with the hazard ratio of 2.991(95 % CI 1.328–6.734;p = 0.008)and 16.593(95 % CI 5.893-46.719,P<0.01),respectively.3.Operation rate at one year of UPJO,for initial APD>1.5cm,initial APD<1.5cm,infancy and after infancy,were 43.20%,2.67%,30.27%,5.95%,respectively.Conclusion: Initial USG is an efficient diagnostic tool to detect pathologic hydronephrosis.Initial APD predicts the clinical outcome of UPJO in pediatrics accurately.Further investigation is recommended when initial APD>1.5 cm.Close observation is needed during the one year after initial visit to detect the deterioration of UPJO,especially in infancy.