Clinical importance of pyelocalyceal dilation diagnosed by postnatal ultrasonographic screening of the urinary tract
Kristina Drnasin, Mirna Saraga-Babić, Marijan Saraga
Med Sci Monit 2013; 19:125-131
Ultrasonographic (US) screening of the urinary tract (UT) in infants was used to determine if there is a connection between the frequency of pyelocaliceal dilation (PCD) in asymptomatic infants with normal antenatal US screening and occurrence of congenital anomalies of kidney and urinary tract (CAKUT) and urinary tract infections (UTI).
Material and Methods: US screening of the UT was performed on 1000 healthy infants, 7 days to 6 months old. Two subgroups of kidneys were described: subgroup 1 contained kidneys with anterior posterior pelvic diameter (APPD) of 5–9.9 mm, and subgroup 2 with APPD over 10 mm. US examinations and methods for detection of UTI and CAKUT were used.
Results: PCD was found in 74 infants (7.4%): 1.9% of infants had CAKUT, and 8.4% had UTI. In subgroup 1, CAKUT was found in 4 (6.3%) and UTI in 9 (14.3%) infants. In subgroup 2, CAKUT was found in 6 (54.5%), and UTI in 4 (36.4%) infants.
Conclusions: Mild PCD significantly increases the risk for CAKUT but not for UTI. Moderate to severe PCD significantly increases risk for both CAKUT and UTI. The postnatal US screening of UT is recommended for improved detection of PCD and associated CAKUT. Indirectly, postnatal US screening of UT can help in detecting people at risk for UTI in the first year of life, and therefore help prevent possible kidney damage.
Keywords: Body Fluids - analysis, Carbon Dioxide - blood, Animals, Aldehyde Oxidoreductases - metabolism, Urinary Tract Infections - ultrasonography, Urinary Tract - ultrasonography, Prone Position, Neonatal Screening, Kidney - ultrasonography, Infant, Newborn, Incidence, Dilatation, Pathologic - ultrasonography, Croatia - epidemiology, Case-Control Studies, Formates - poisoning, Haplorhini, Hydrogen-Ion Concentration, Kinetics, Methanol - blood, Methods, Pseudomonas - enzymology