Clinical Significance of Supranormal Differential Renal Function in the Recovery of Hydronephrosis

Study Overview
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Brief Summary
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The purpose of this study is to assess the clinical significance of supranormal differential renal function (DRF) in the recovery of unilateral hydronephrosis (HN) after surgery, pediatric patients who underwent pyeloplasty for ureteropelvic junction obstruction (UPJO) who showed supranormal DRF (> 55%) in the DTPA renography will be analyzed.

Detailed Description
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To assess the clinical significance of supranormal differential renal function (DRF) in the recovery of unilateral hydronephrosis (HN) after surgery, pediatric patients who underwent pyeloplasty for ureteropelvic junction obstruction (UPJO) who showed supranormal DRF (> 55%) in the DTPA renography will be analyzed. Clinical parameters including age at the first visit, age at operation, gender, laterality, and follow-up period will be evaluated. To evaluate predictors of recovery from supranormal renal function according to the level of DRF, univariate and multivariate logistic regression analyses will be performed. Patients would be subcategorized into two groups; group A (DRF ≤60%) and group B (DRF >60%) in consideration of the mean value of preoperative DRF and each parameter of group A was compared to that of group B using independent sample's t test and chi square test. Kaplan-Meier analysis and log-rank test will be used to determine the difference of recovery time of obstructed hydronephrosis in each parameter.

Official Title
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Clinical Significance of Supranormal Differential Renal Function in the Recovery of Unilateral Hydronephrosis After Surgery: Long-term Results

Conditions
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Hydronephrosis

Intervention / Treatment
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* Procedure: dismembered pyeloplasty


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: ureteropelvic junction obstruction hydronephrosis differential renal function more than 55% in DTPA follow-up period more than 1 year Exclusion Criteria: urological anomalies, such as vesicoureteral reflux, ureterocele, cystic kidney disease, posterior urethral valves, duplex anomalies, neurogenic bladder, and solitary kidney or patients who underwent any previous urological surgery

Ages Eligible for Study
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Maximum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| patients with supranormal renal function<br>Patients with preoperative HN and supranormal renal function in DTPA renography | Procedure: dismembered pyeloplasty<br>* Using a flank approach, as the patient was placed in the lateral decubitus position, and an anterior subcostal incision was made. The narrow segment of UPJ was identified and resected, and then the proximal edge of the ureter was spatulated to allow a wide anastomosis between the ureter and the most dependent part of the renal pelvis. The extent of renal pelvis reduction was decided by the surgeon.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Hydronephrosis | The grade of hydronephrosis would be check at 6 months postoperatively. | postop 6 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| renal parenchymal thickness | Renal parenchymal thickness was measured. | postop 6 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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hydronephrosis, ultrasonography, Kidney Function Test, Patients with unilateral UPJO and patients with preop HN in USG and supranormal renal function in DTPA renography