Renal Parenchyma to Hydronephrosis Area Ratio (PHAR) as a Predictor of Future Surgical Intervention for Infants With High-grade Prenatal Hydronephrosis.
Objective: To explore the potential value of an objective assessment, renal parenchyma to hydronephrosis area ratio (PHAR), as an early predictor of surgery.Methods: Initial sagittal renal ultrasound (US) images of patients prospectively entered into a prenatal hydronephrosis database from January 2...
| Published in: | Urology Vol. 101; no. 1; pp. 85 - 90 |
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| Main Authors: | , , |
| Format: | clinical trial research Journal Article |
| Published: |
Elsevier B.V.
Mar2017
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=121556523&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 121556523 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00904295 1YG jtl: Urology issn: 00904295 maglogo: N pubinfo: dt: Mar2017 vid: 101 iid: 1 pid: 467 pub: Elsevier B.V. place: New York, New York artinfo: ui: 121556523 121556523 NLM27713070 121556523 10.1016/j.urology.2016.09.029 NLM27713070 121556523 ppf: 85 ppct: 5 formats: tig: atl: Renal Parenchyma to Hydronephrosis Area Ratio (PHAR) as a Predictor of Future Surgical Intervention for Infants With High-grade Prenatal Hydronephrosis. aug: au: Rickard, Mandy Lorenzo, Armando J. Braga, Luis H. affil: Department of Surgery and McMaster Pediatric Surgery Research Collaborative, McMaster University, Ontario, Canada sug: subj: Ureteral Obstruction Complications Kidney Ureter Ultrasonography, Prenatal Methods Surgery, Urogenital Hydronephrosis Diagnosis Human Time Factors Ureteral Obstruction Diagnosis Infant Disease Progression Prospective Studies Infant, Newborn Hydronephrosis Etiology Ureter Abnormalities ROC Curve Predictive Value of Tests Hydronephrosis Surgery Severity of Illness Indices Ureteral Obstruction Female Kidney Pelvis Pregnancy Clinical Trials Validation Studies Comparative Studies Evaluation Research Multicenter Studies Infant: 1-23 months Infant, Newborn: birth-1 month Female ab: Objective: To explore the potential value of an objective assessment, renal parenchyma to hydronephrosis area ratio (PHAR), as an early predictor of surgery.Methods: Initial sagittal renal ultrasound (US) images of patients prospectively entered into a prenatal hydronephrosis database from January 2008 to January 2016 with baseline Society for Fetal Urology (SFU) grades III and IV prenatal hydronephrosis, without vesicoureteral reflux, were evaluated using the National Institutes of Health-sponsored image processing software. PHAR, anteroposterior diameter, SFU grade, and urinary tract dilation risk categories were contrasted with nuclear scan data (differential renal function and drainage time [t1/2]) and analyzed for predictive value in determining the decision to proceed with surgery by drawing receiver operating characteristic curves.Results: Out of 196 infants (162 male; 138 left sided hydronephrosis), 58 (30%) underwent surgery to address obstruction. Surgical patients compared with those managed conservatively had longer t1/2 (60 vs 18 min; P < .01) and lower differential renal function (46 vs 50%; P = .01). Of the initial US parameters, PHAR (area under the curve = 0.816; P < .001) had a better predictive performance than anteroposterior diameter, SFU grade, or urinary tract dilation classification. PHAR values correlated with subsequent parameters obtained on nuclear scan.Conclusion: PHAR is a promising parameter that can be estimated on presentation US to help predict future need for surgery in newborns with high-grade hydronephrosis. pubtype: Academic Journal doctype: clinical trial research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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