Ultrasound screening of the kidneys and urinary tract in 11.887 newborn infants: A 10-year experience

Abstract

Objective: To determine the usefulness of sonographic screening of the newborn kidneys and urinary tract over a 10-year time period. Methods: Ultrasound screening of the kidneys and the urinary tract was performed between the third and tenth day after birth on 11.887 newborn infants. The classification of renal pyelectasis (RPE) according to the Society for Fetal Urology (SFU) was used. We evaluated infant renal pathologies and correlated them with the gestational age and weight at birth. Results: Renal pyelectasis (grades 1-4) was detected in 179 cases (1.5%); it was significantly more common in male (vs female) infants (p < 0.001). One- (vs two-) sided dilatation of the renal pelvis was more common, with the left side dominating (p< 0.05). Renal pyelectasis was occasionally associated with parenchymal and positional anomalies, such as nephrocalcinosis (0.27%), double kidneys (0.24%), horseshoe kidneys (0.11%), pelvic kidneys (0.08%), multicystic (0.07%) and polycystic (0.025%) kidneys. In infants with renal pyelectasis grade 4 (n = 36), gestational diabetes mellitus of the mother and birth weight > 4.000 g were the most significant risk factors (p < 0.01). Conclusions: Renal pyelectasis grades 1-4 was detected in only 1.5% of 11.887 consecutive infants subjected to sonographic screening of the kidneys and the urinary tract within the first 10 days after birth. Sonographic screening of the kidneys and the urinary tract is a non-invasive and effective screening method after birth. It allows planning for appropriate diagnostic tests and therapeutic procedures in a timely fashion.

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E. Gruessner, S. , Klein, K. , Peter, C. , Bueltmann, E. , Wagner, J. and Klingmueller, V. (2012) Ultrasound screening of the kidneys and urinary tract in 11.887 newborn infants: A 10-year experience. Open Journal of Obstetrics and Gynecology, 2, 389-393. doi: 10.4236/ojog.2012.24080.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] Carrera, J.M., Torrents, M., Mortera, C., Cusi, V. and Munoz, A. (1995) Routine prenatal ultrasound screening for fetal abnormalities: 22 years’ experience. Ultrasound in Obstetrics & Gynecology, 5, 174-179. doi:10.1046/j.1469-0705.1995.05030174.x
[2] Hiraoka, M., Hori, C., Tsukahara, H., Kasuka, K., Ishihara, Y., Kotsuji, F. and Mayumi, M. (1999) Vesicoureteral reflux in male and female neonates as detected by voiding ultrasonography. Kidney International, 55, 1486-1490. doi:10.1046/j.1523-1755.1999.00380.x
[3] Palmer, L.S., Maiselz, M., Cartwright, P., Fernbach, S.K. and Conway, J.J. (1998) Surgery versus observation for managing obstructive grade 3 to 4 unilateral hydronephrosis: A report from the Society for Fetal Urology. The Journal of Urology, 159, 222-228. doi:10.1016/S0022-5347(01)64072-2
[4] Fasolato, V., Poloniato, A., Bianchi, C., Spagnolo, D., Valsecchi, L., Ferrari, A., Paesano, P. and Del Maschio, A. (1998) Feto-neonatal ultrasonography to detect renal abnormalities. American Journal of Perinatology, 15, 161-164. doi:10.1055/s-2007-993918
[5] Anderson, N.G., Abbott, G.D., Mogridge, N., Allan, R.B., Meling, T.M. and Wells, J.E. (1997) Vesicoureteric reflux in the newborn: Relationship to fetal renal pelvic diameter. Pediatric Nephrology, 11, 610-616. doi:10.1007/s004670050348
[6] Fanos, V., Agostiniani, R. and Cataldi, L. (2000) Pyelectasis and hydronephrosis in the newborn and infant. Acta Paediatrica, 89, 900-904. doi:10.1111/j.1651-2227.2000.tb00404.x
[7] Park, J.M. and Bloom, D.A. (1998) The pathophysiology of UPJ obstruction: Current concepts. The Urologic Clinics of North America, 25, 161-169. doi:10.1016/S0094-0143(05)70004-5
[8] Fernbach, S.K., Maizels, M. and Conway, J.J. (1993) Ultrasound grading of hydronephrosis: introduction to the system used by the Society for Fetal Urology. Pediatric Radiology, 23, 478-480. doi:10.1007/BF02012459
[9] Blane, C.E., DiPietro, M.A., Strouse, P.J., Koo, H.P. and Bloom, D.A. (2003) Pediatric renal pelvic fullness: An ultrasonographic dilemma. The Journal of Urology, 170, 201-203. doi:10.1097/01.ju.0000065246.62888.c0
[10] Thomas, D.F., Madden, N.P., Irving, H.C. and Arthur, R.J. (1994) Mild dilatation of the fetal kidney: A follow-up study. British Journal of Urology, 74, 236-239. doi:10.1111/j.1464-410X.1994.tb16593.x
[11] Wong, D.C., Anderson, P.A., Macken, M. and Jackson, J.R. (1999) Congenital hydronephrosis who requires intervention? Canadian Journal of Urology, 6, 812-818.
[12] Schuster, W. (1990) Kinderradiologie 2. Springer-Verlag, Berlin, 611-653.
[13] Chudleigh, T. (2001) Mild pyelectasis. Prenatal Diagnosis, 21, 936-941. doi:10.1002/pd.204
[14] Dremsek, P.A., Gindl, K., Voitl, P., Strobl, R., Hafner, E. and Geissler, W. (1997) RPE in fetuses and neonates: Diagnostic value of renal pelvis diameter in pre- and post-natal sonographic screening. American Journal of Roentgenology, 168, 1017-1019.
[15] Yeung, C.K., Godley, M.L., Dhillon, H.K., Gordon, I, Duffy, P.G. and Ransley, P.G. (1997) The characteristics of primary vesico-ureteric reflux in male and female infants with prenatal hydronephrosis. British Journal of Urology, 80, 319-327. doi:10.1046/j.1464-410X.1997.00309.x
[16] Hiraoka, M., Morikawa, K., Hori, C., Tsuchida, S., Kasuga, K. and Tominaga, T. (1995) Left renal pelvis of male neonates is predisposed to dilatation. Acta Paediatrica Japan, 37, 352-354.
[17] Yoshida, J., Tsuchiya, M., Tatsuma, N. and Murakami, M. (2003) Mass screening for early detection of congenital kidney and urinary tract abnormalities. Pediatrics International, 5, 142-149. doi:10.1046/j.1442-200X.2003.01681.x
[18] Bartoli, F.A., Paradies, G., Leggio, A., Virgintino, D., Bertossi, M. and Roncali, L. (1996) Urothelium damage as the primary cause of ureteropelvic junction obstruction. Urological Research, 24, 9-13. doi:10.1007/BF00296726
[19] Kapadia, H., Lidefelt, K.J., Erasmie, U. and Pilo, C. (2004) Antenatal renal pelvis dilatation emphasizing vesicoureteric reflux: Two-year follow-up of minor postnatal dilatation. Acta Paediatr, 93, 336-339. doi:10.1111/j.1651-2227.2004.tb02957.x
[20] Tsai, J.D., Huang, F.U. and Tsai, T.C. (1998) Asymptomatic vesicoureteral reflux detected by neonatal ultrasonographic screening. Pediatric Nephrology, 12, 206-209. doi:10.1007/s004670050438
[21] Tsuchiya, M., Hayashida, M., Yanagihara, T., Yoshida, J., Takeda, S., Tatsuma, T.H., Hino, Y., Munakata, E. and Murakami, M. (2003) Ultrasound screening for renal and urinary tract anomalies in healthy infants. Pediatrics International, 45, 617-623. doi:10.1046/j.1442-200X.2003.01780.x
[22] Peters, C.A. (1995) Urinary tract obstruction in children. The Journal of Urology, 154, 1874-1883. doi:10.1016/S0022-5347(01)66815-0
[23] Ismaili, K., Avni, F.E., Martin, W.K., Hall, M. and Brussels Free University Perinatal Nephrology Study Group (2004) Long-term clinical outcome of infants with mild and moderate fetal pyelectasis: validation of neonatal ultrasound as a screening tool to detect significant nephrouropathies. The Journal of Pediatrics, 144, 759-765.
[24] Koff, S.A. (1998) Neonatal management of unilateral hydronephrosis: Role for delayed intervention. Urologic Clinics of North America, 25, 181. doi:10.1016/S0094-0143(05)70006-9
[25] Chertin, B., Friedmans, A., Knizhnik, M., Hadas-Halperin, I., Hain, D. and Farkas, A. (1999) Does early detection of ureteropelvic junction obstruction improve surgical outcome in terms of renal function? The Journal of Urology, 162, 1037-1040. doi:10.1016/S0022-5347(01)68058-3
[26] Ulman, I., Jayanthi, V.R. and Koff, S.A. (2000) The long- term follow up of newborns with severe unilateral hydronephrosis initially treated nonoperatively. The Journal of Urology, 164, 1101-1105. doi:10.1016/S0022-5347(05)67262-X

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