Predictor Factor for Severity Degree of Pediatric Hydronephrosis in Tertiary Hospital

H. Naim, B. Daryanto, Pradana Nurhadi
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Abstract

Pediatric hydronephrosis is often hideous, and its severity highly correlates with a significantly increased incidence of pathological condition and outcome. The management of this disease is based on the severity level by identifying the clinical manifestation, so performing an early detection is crucial to prevent the disease progression. This research aimed to determine the predictor factors for the severity degree of pediatric hydronephrosis to give better treatments for patients. This study retrospectively reported 51 data of hydronephrosis cases that were collected from January 2012 to August 2019. Severity degree was evaluated using SFU (Society of Fetal Urology) scoring system and divided into two groups, mild-moderate (first and second degree) and moderate-severe (third and fourth degree). Data including age, gender, number of kidneys affected, etiology, and antenatal care were collected and statistically analyzed using Pearson's Chi-square and Fischer Exact test. The research result from 51 pediatric patients, 72.55% were categorized as moderate-severe hydronephrosis while the remaining 27.45% were categorized ad mild-moderate hydronephrosis. Ureteropelvic junction (UPJ) stenosis (37.25%) is the most common cause of pediatric hydronephrosis. Significant correlations are noted among severity degree and gender, the number of kidneys affected, etiology, and chosen antenatal care between obstetrician-gynecologist and midwife (p<0.05). In short, gender, number of kidneys affected, etiology, patient's choice on antenatal care can be the predictor factors for pediatric hydronephrosis. Thus, these findings are essential for urologists in pediatric hydronephrosis management.
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三级医院儿童肾积水严重程度的预测因素
儿童肾积水通常是可怕的,其严重程度与病理状况和预后的发生率显著增加高度相关。该病的管理是基于临床表现的严重程度,因此早期发现对预防疾病进展至关重要。本研究旨在确定儿童肾积水严重程度的预测因素,为患者提供更好的治疗。本研究回顾性报告了2012年1月至2019年8月收集的51例肾积水病例资料。严重程度采用SFU (Society of Fetal Urology)评分系统进行评分,分为轻度-中度(一、二度)和中度-重度(三、四度)两组。收集年龄、性别、受影响肾脏数量、病因、产前护理等资料,采用Pearson’s卡方检验和Fischer精确检验进行统计学分析。研究结果51例患儿中,72.55%为中重度肾积水,其余27.45%为轻中度肾积水。肾盂输尿管连接处(UPJ)狭窄(37.25%)是儿童肾积水最常见的原因。严重程度与性别、受影响肾脏数量、病因、选择的产前护理在妇产科医生和助产士之间存在显著相关性(p<0.05)。总之,性别、受影响的肾脏数量、病因、患者对产前护理的选择可能是儿童肾积水的预测因素。因此,这些发现对泌尿科医生在小儿肾积水处理中至关重要。
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