Assessing the Effectiveness of Treatment for Congenital Hydronephrosis in Children
Keywords:
High-grade dilatation, hydronephrosis, progressive dilatationAbstract
Congenital hydronephrosis is one of the most frequently detected urinary tract abnormalities during the antenatal period. Its clinical significance ranges from mild, transient pyelectasis to obstructive uropathies that may lead to progressive deterioration of renal function. The widespread implementation of antenatal ultrasonography has substantially increased the detection of fetal urinary tract dilatation. Studies conducted in European countries have reported a prevalence of congenital hydronephrosis of 11.5 cases per 10,000 births; in 86% of affected children, the renal anomaly was isolated. Not all cases of antenatally detected hydronephrosis are associated with pathological obstruction. The literature indicates that approximately one-third of antenatal urinary tract dilatations may regress before birth, while another proportion may resolve spontaneously during the first years of life. However, persistent or high-grade dilatation may be associated with ureteropelvic junction obstruction, vesicoureteral reflux, and other congenital anomalies of the kidneys and urinary tract. Therefore, the key clinical issue is not merely early detection of hydronephrosis, but also accurate assessment of its clinical significance and timely identification of children at risk of renal functional impairment.
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