Mp72-11 the Correlation Between Renal Medullary Pyramidal Thickness, Parenchymal Thickness, and Differential Renal Function in Hydronephrotic Kidneys

You have accessJournal of UrologyPediatrics VII (MP72)1 May 2024MP72-11 THE CORRELATION BETWEEN RENAL MEDULLARY PYRAMIDAL THICKNESS, PARENCHYMAL THICKNESS, AND DIFFERENTIAL RENAL FUNCTION IN HYDRONEPHROTIC KIDNEYS Dana A. Soukup, Hanh T. D. Pham, Angelena B. Edwards, Gina M. Lockwood, Douglas W. Storm, and Christopher S. Cooper Dana A. SoukupDana A. Soukup , Hanh T. D. PhamHanh T. D. Pham , Angelena B. EdwardsAngelena B. Edwards , Gina M. LockwoodGina M. Lockwood , Douglas W. StormDouglas W. Storm , and Christopher S. CooperChristopher S. Cooper View All Author Informationhttps://doi.org/10.1097/01.JU.0001009572.60675.69.11AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: A renal medullary pyramidal thickness (PT) of 3 mm or less is associated with an increased risk of UPJ obstruction and pyeloplasty in children with congenital hydronephrosis. A relatively common indication for operative intervention in a congenitally hydronephrotic kidney is a differential renal function (DRF) less than 40 percent. The objective of this study was to evaluate the correlation between the PT and renal parenchymal thickness with the DRF as determined by nuclear renal scan (MAG3) in patients with unilateral hydronephrosis. METHODS: A retrospective review of the renal ultrasound and MAG3 imaging in 98 children with grade 3 and 4 unilateral hydronephrosis was performed. The median (IQR) age was 112 days (43-274) at renal scan and 120 days (40-254) at the ultrasound. The median (IQR) days from ultrasound to renal scan was 0 (0-15) days. The largest PT and the parenchymal thickness were measured in the middle of the kidney on a midsagittal plane on ultrasound in both the hydronephrotic and contralateral non-hydronephrotic kidney. Spearman's correlation coefficient and Fisher's p-values were calculated. RESULTS: No kidney with a PT >3 mm, or a kidney with parenchymal thickness >5 mm, had a DRF <40% (p=0.008 and p=0.006). 17% of kidneys with a PT of 3mm or less, and 18% of kidneys with a parenchymal thickness of 5 mm or less, had a DRF <40%. There was a weak positive relationship between the ratio of PT in the hydronephrotic kidney to the PT in the contralateral non-hydronephrotic PT with the DRF of the hydronephrotic kidney (Spearman's correlation coefficient: 0.21, p value: 0.04). The ratio of parenchymal thickness (hydronephrotic to contralateral non-hydronephrotic) did not quite reach statistical significance (p value of 0.05). CONCLUSIONS: Our findings demonstrate that a PT greater than 3 mm, or a total parenchymal thickness greater than 5 mm serve to identify hydronephrotic kidneys with a relative renal function >40%. Use of these ultrasound measurements may therefore be useful in selecting and limiting renal scans and radiation exposure in children with higher grades of hydronephrosis. Download PPT Source of Funding: Tyrone D. Artz Chair in Urology © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e1175 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Dana A. Soukup More articles by this author Hanh T. D. Pham More articles by this author Angelena B. Edwards More articles by this author Gina M. Lockwood More articles by this author Douglas W. Storm More articles by this author Christopher S. Cooper More articles by this author Expand All Advertisement PDF downloadLoading ...