Abstract

Purpose

To determine if children with UPJO demonstrate a clinically significant change in somatic growth following pyeloplasty.

Methods

We retrospectively evaluated the growth chart data of infants with SFU grade 3 or 4 congenital hydronephrosis at our institution from 2015 to 2022. Of those, 35 patients underwent pyeloplasty and 66 had no surgical intervention. Patients met criteria if they had SFU 3 or 4 hydronephrosis and MAG3 renal scan. If patients underwent surgery, height and weight percentiles were recorded from the pre-op and 6–16-month follow-up visits. In non-surgery patients, measurements were taken near the median age of surgery in the intervention group and 6–16 months later. Interval changes in group height and weight percentiles are compared for significant changes.

Results

The surgery and non-surgery groups did not differ in terms of gender (71% vs 74% Male), starting age (296 vs 244 days), starting weight (58th vs 52nd percentile), or time between measurements (255 vs 260 days), though the surgery group had significantly less height in the pre-operative period (43rd vs 55th percentile, p = 0.050) and were more likely to have delayed drainage on renal scan (83% w/delay vs 35%). The surgery group showed a significant increase in height (18.9 percentiles; 95% CI 11–27) and weight (6.0 percentiles; 95% CI 0.50–12) after intervention.

Conclusions

Patients with congenital hydronephrosis due to UPJO that underwent pyeloplasty showed a significant increase in weight and height at 6–16 months postoperatively compared to those that were managed with close observation. This suggests UPJO might lead to growth delay in infants.

中文翻译：

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肾盂成形术可以逆转婴儿肾盂输尿管连接部梗阻造成的生长迟缓的影响

摘要

目的

确定患有 UPJO 的儿童在肾盂成形术后是否表现出临床上显着的体细胞生长变化。

方法

我们回顾性评估了我院2015年至2022年SFU 3级或4级先天性肾积水婴儿的生长图数据。其中，35例患者接受了肾盂成形术，66例未接受手术干预。如果患者有 SFU 3 或 4 级肾积水和 MAG3 肾脏扫描，则符合标准。如果患者接受手术，则记录术前和 6-16 个月随访的身高和体重百分位数。对于非手术患者，测量是在干预组手术中位年龄附近以及 6-16 个月后进行的。比较组身高和体重百分位数的间隔变化是否有显着变化。

结果

手术组和非手术组在性别（71% 与 74% 男性）、起始年龄（296 天与 244 天）、起始体重（第 58 个百分位数与第 52 个百分位）或测量间隔时间（255 天与 260 天）方面没有差异。 ），尽管手术组在术前的身高明显较低（第 43 个百分点与第 55 个百分点，p  = 0.050），并且更有可能在肾脏扫描中出现延迟引流（83% 延迟 vs 35%）。干预后，手术组的身高（18.9 个百分位；95% CI 11-27）和体重（6.0 个百分位；95% CI 0.50-12）显着增加。

结论

与密切观察的患者相比，因 UPJO 导致先天性肾积水的患者在术后 6-16 个月时体重和身高显着增加。这表明 UPJO 可能会导致婴儿生长迟缓。