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Pediatr Int. 2019 Jan 13. doi: 10.1111/ped.13788. [Epub ahead of print]

Value of Renal Pelvic Diameter and UTD classification in Prediction of Urinary Tract Anomalies.

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Dr. Sami, Ulus Maternity and Child Health and Diseases Training and Research Hospital, Department of Pediatric Nephrology, Ankara.
19 Mayis University Medical School, Department of Pediatric Nephrology, Samsun.
Yıldırım Beyazıt University Medical School, Department of Pediatric Nephrology.
Antalya Training and Research Hospital, Department of Pediatric Nephrology, Antalya.



In this study, we aimed to identify the cut-off values of postnatal anteroposterior renal pelvic diameter (APRPD) and we present our data based on the Urinary Tract Dilation (UTD) classification system to identify the predictors for final diagnosis of urinary tract dilation and the need for surgery.


A total of 260 infants (336 renal units) with prenatally detected urinary tract dilation were prospectively evaluated with serial ultrasonography by the same radiologist. Additional radiological assessments with voiding cystourethrography and scintigraphy were done according to our clinical algorithm.


Prenatal and postnatal APRPD of patients with transient dilation were significantly lower than those with urinary tract anomalies (UTA). On follow-up, the slope of decrease in APRPD was significantly higher in transient dilation compared to UTA. An APRPD of 10 mm at first-month ultrasonography, predicted the UTA with a sensitivity of 83.1%, and specificity of 71.1%. Multivariate analysis revealed that the likelihood of surgical intervention and final diagnosis were predicted independently by the UTD system risk group.


Careful ultrasonography evaluation can give important clues that avoids unnecessary testing in patients with transient or clinically insignificant dilation. The UTD classification system is valid for evaluation of postnatal hydronephrosis and is reliable in predicting the need for surgical intervention. This article is protected by copyright. All rights reserved.


Antenatal hydronephrosis; renal pelvic diameter; ureteropelvic junction obstruction; urinary tract dilation ; vesicoureteral reflux


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