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Erschienen in:

01.12.2023 | Original Article

Management of non-functioning kidney due to pelvi-ureteric junction obstruction in pediatric age group: an observational study

verfasst von: Rahul Kumar Rai, Anand Pandey, Shashwat Verma, Nitin Pant, Sudhir Singh, Nirpex Tyagi, Piyush Kumar, Jiledar Rawat

Erschienen in: Pediatric Surgery International | Ausgabe 1/2023

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Abstract

Introduction

A non-functional kidney (NFK) has been defined as one having paper-thin parenchyma, and split renal function (SRF) of < 10% on a nuclear scan. There are differences of opinion about nephrectomy or pyeloplasty in these patients. The present study was conducted to assess our management strategy of renal salvage for NFK.

Materials and methods

It was a retrospective cohort study from January 2015 to July 2022, patients having SRF < 10% were included. These patients underwent ultrasound-guided percutaneous nephrostomy (PCN). A repeat nuclear scan was performed after 3 months. If SRF increased to > 10%, pyeloplasty was performed.

Results

Fifteen patients were managed. The mean age was 24.67 ± 23.61 months. Male to female ratio was 4:1. The initial mean SRF was 6.67 ± 2.85, which improved to 16.80 ± 4.69 after 3 months of placing the PCN (p < 0.001). The corresponding changes in the mean effective renal plasma flow (ERPF) were 60.13 ± 24.08 to 106.53 ± 24.61 (p < 0.001). There was no complaint after the placement of PCN. All patients underwent dismembered pyeloplasty.

Conclusion

In NFK due to PUJO, expectant treatment in form of PCN followed by pyeloplasty appears to be the primary treatment modality, and nephrectomy may not be needed in any of them.

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Titel: Management of non-functioning kidney due to pelvi-ureteric junction obstruction in pediatric age group: an observational study
verfasst von: Rahul Kumar Rai
Anand Pandey
Shashwat Verma
Nitin Pant
Sudhir Singh
Nirpex Tyagi
Piyush Kumar
Jiledar Rawat
Publikationsdatum: 01.12.2023
Verlag: Springer Berlin Heidelberg
Erschienen in: Pediatric Surgery International / Ausgabe 1/2023
Print ISSN: 0179-0358
Elektronische ISSN: 1437-9813
DOI: https://doi.org/10.1007/s00383-023-05368-3

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Management of non-functioning kidney due to pelvi-ureteric junction obstruction in pediatric age group: an observational study