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Diseases and Conditions › Pediatric Nephrology › Hydronephrosis

Hydronephrosis

Kumud P Mehta
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Antenatal USG Evaluation Includes

- Serial measurements of renal pelvic AP diameter every 4-6 weekly from 16th week onwards(>10mm significant),
- Dilation of calyces, ureters
- Echogenicity of renal parenchyma
- Contralateral kidney size, dilation
- Bladder size and thickness
- Emptying time; urine flow
- Amniotic fluid volume( oligohydramnios means poor fetal renal function)
- Posterior urethral dilation

Antenatal USG evaluation of HDN can detect the above mentioned causes, which need confirmation postnatally by clinical evaluation, micturating cystourethrography (MCU), radionucleide Tc99DTPA or MAG renal scan.

Postnatal Evaluation of Hydronephrosis

At birth:
Clinical examination to observe urinary stream (poor in PU valves), renal masses, distended bladder which is firm in PU valves, abdominal wall muscles, undescended testes (Prune belly syndrome). (In suspected PU valves - immediate catheterisation is required to drain the urinary bladder and relieve back pressure).

USG, MCU, serum creatine / BUN (to be repeated after 6 weeks of relief of obstruction to evaluate effect of obstruction on renal function).

<< Hydronephrosis - Introduction

Approach to Unilateral Hydronephrosis >>

Hydronephrosis - Introduction
Common Causes of Hydronephrosis
Acquired Hydronephrosis
Approach to Unilateral Hydronephrosis
Approach to Bilateral Mild to Moderate HDN
Indications of Surgery In HDN
Management of Hydronephrosis
Hydronephrosis - Patient Education

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