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Mild dilatation of the fetal kidney: a follow‐up study
Author(s) -
THOMAS D.F.M.,
MADDEN N.P.,
IRVING H.C.,
ARTHUR R.J.,
SMITH S.E.W.
Publication year - 1994
Publication title -
british journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 0007-1331
DOI - 10.1111/j.1464-410x.1994.tb16593.x
Subject(s) - medicine , ultrasound , renal pelvis , cystourethrography , urinary system , reflux , fetus , pelvis , kidney , surgery , vesicoureteral reflux , urology , radiology , pregnancy , disease , genetics , biology
Objective To assess morbidity in children with mild prenatally detected pelvicalyceal dilatation and to document the natural history of this ultrasound finding in post‐natal life. Patients and methods A retrospective (on‐going) study was carried out in 29 children (39 kidneys) with mild dilatation confined to the pelvis and/or calices confirmed on initial post‐natal ultrasound scan. Re‐evaluation was carried out at a mean age of 4.2 years (range 1.5–7.8). Clinically, each patient's history, height, weight and blood pressure were recorded. On ultrasound examination the renal length, collecting system appearances and dimensions were recorded. Results Vesico‐ureteric reflux was demonstrated in 1 of 14 infants who underwent neonatal micturating cystourethrography. During cumulative follow‐up totalling 122 years, there were only two documented episodes of urological morbidity, i.e. one episode of unexplained haematuria and one of urinary tract infection. By a mean age of 4.2 years the ultrasound appearances had reverted to normal in 69% of kidneys. In 31% dilatation persisted and was unchanged or diminished in severity. No case of increasing dilatation was seen. Renal growth was normal in 9 7%) of kidneys. Conclusions Mild dilatation of the fetal urinary tract is a common prenatal ultrasound finding. When confined to the renal pelvis and/or calices it is of doubtful clinical significance and is associated with a low level of morbidity in infancy and early childhood. Invasive investigation in post‐natal life is not justified.