Abstract
In utero diagnosis of hydronephrosis may allow early surgical intervention with possible beneficial effects on the long term renal function. We have prospectively followed 13 of such neonates with grade 3-4 hydronephrosis who had been operated in the first month of life. 10 stenosis of the pyelouretheral junction (5 monolateral), 2 vescicouretheral reflux (1 monolateral), 1 uretral valves. Serum creatinine, electrolytes, maximal urinary concentrating ability after DDAVP, urinary acidification and ammoniogenesis after oral NH4Cl, PRA and serum aldosterone concentration were measured at various intervals. The follow up ranges from 4 to 40 months. Creatinine clearance was normal in all infants at all ages, reduced concentrating ability (Osmu 700) was present in 11/13 infants 9 months but tended to disappear after 2 months. 10/13 infants had mild hyperkalemia (K+5.5-6.5 mEq/1) during the first months. This was accompanied by serum aldosterone concentrations exceeding the normal values for age and suggests a reduced tubular response to aldosterone. A deficient ammoniogenesis was present in 3/13 subjects but all could normally lower U pH below 5.5. UTIs were a minor problem (0.5 episodes/months/infant). These results indicate that mild tubular impairment is present in neonates with congenital hydronephrosis after neonatal surgical correction and tend to ameliorate gradually.
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Marra, G., Dell' agnola, C., Goi, V. et al. RENAL FUNCTION IN INFANTS WITH CONGENITAL HYDRONEPHROSIS OPERATED IN THE FIRST MONTH OF LIFE. Pediatr Res 19, 1081 (1985). https://doi.org/10.1203/00006450-198510000-00082
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DOI: https://doi.org/10.1203/00006450-198510000-00082