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Please use this identifier to cite or link to this item: http://hdl.handle.net/1843/57391
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dc.creatorFernanda P. Costapt_BR
dc.creatorAna C. Simões e Silvapt_BR
dc.creatorRobert H. Makpt_BR
dc.creatorJoachim H. Ixpt_BR
dc.creatorMariana A. Vasconcelospt_BR
dc.creatorCristiane Dos Santos Diaspt_BR
dc.creatorCarolina C. Fonsecapt_BR
dc.creatorMaria Christina L. Oliveirapt_BR
dc.creatorEduardo A. Oliveirapt_BR
dc.date.accessioned2023-08-02T22:25:24Z-
dc.date.available2023-08-02T22:25:24Z-
dc.date.issued2019-08-19-
dc.citation.volume13pt_BR
dc.citation.issue5pt_BR
dc.citation.spage834pt_BR
dc.citation.epage841pt_BR
dc.identifier.doihttps://doi.org/10.1093/ckj/sfz102pt_BR
dc.identifier.issn2048-8513pt_BR
dc.identifier.urihttp://hdl.handle.net/1843/57391-
dc.description.resumoBackground. Antenatal hydronephrosis (ANH) affects 1–5% of pregnancies. The aim of this study was to develop a clinical prediction model of renal injury in a large cohort of infants with isolated ANH. Methods:This is a longitudinal cohort study of 447 infants with ANH admitted since birth between 1989 and 2015 at a tertiary care center. The primary endpoint was time until the occurrence of a composite event of renal injury, which includes proteinuria, hypertension and chronic kidney disease (CKD). A predictive model was developed using a Cox proportional hazards model and evaluated by C-statistics.Results: Renal pelvic dilatation (RPD) was classified into two groups [Grades 1–2 (n ¼ 255) versus Grades 3–4 (n ¼ 192)]. The median follow-up time was 6.4 years (interquartile range 2.8–12.5). Thirteen patients (2.9%) developed proteinuria, 6 (1.3%) hypertension and 14 (3.1%) CKD Stage 2. All events occurred in patients with RPD Grades 3–4. After adjustment, three covariables remained as predictors of the composite event: creatinine {hazard ratio [HR] 1.27, [95% confidence interval (CI) 1.05–1.56]}, renal parenchyma thickness at birth [HR 0.78(95% CI 0.625–0.991)] and recurrent urinary tract infections [HR 4.52 (95% CI 1.49–13.6)]. The probability of renal injury at 15 years of age was estimated as 0, 15 and 24% for patients assigned to the low-risk, medium-risk and high-risk groups, respectively (P < 0.001).Conclusion: Our findings indicate an uneventful clinical course for patients with Society for Fetal Urology (SFU) Grades 1–2 ANH. Conversely, for infants with SFU Grades 3–4 ANH, our prediction model enabled the identification of a subgroup of patients with increased risk of renal injury over time.pt_BR
dc.format.mimetypepdfpt_BR
dc.languageengpt_BR
dc.publisherUniversidade Federal de Minas Geraispt_BR
dc.publisher.countryBrasilpt_BR
dc.publisher.departmentMED - DEPARTAMENTO DE PEDIATRIApt_BR
dc.publisher.initialsUFMGpt_BR
dc.relation.ispartofClinical Kidney Journal-
dc.rightsAcesso Abertopt_BR
dc.subjectAntenatal hydronephrosispt_BR
dc.subjectChronic kidney diseasept_BR
dc.subjectClinical prediction modelpt_BR
dc.subjecthypertensionpt_BR
dc.subjectProteinuriapt_BR
dc.subjectRenal injurypt_BR
dc.subjectUrinary tract infectionpt_BR
dc.subject.otherInsuficiência Renal Crônicapt_BR
dc.subject.otherHipertensãopt_BR
dc.subject.otherProteinuriapt_BR
dc.subject.otherInjúria Renal Agudapt_BR
dc.subject.otherInfecções Urináriaspt_BR
dc.titleA clinical predictive model of renal injury in children with isolated antenatal hydronephrosispt_BR
dc.typeArtigo de Periódicopt_BR
dc.url.externahttps://academic.oup.com/ckj/article/13/5/834/5551403pt_BR
dc.identifier.orcid0000-0001-6559-3300pt_BR
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